title: Elimination of NTproBNP in peritoneal dialysis patients. Does peritoneal membrane type make a difference in plasma level and elimination of NTproBNP?
abstract: BACKGROUND
  Brain natriuretic peptide and its derivative peptide NTproBNP are utilized to exclude cardiac diseases, and predicting risk of mortality in dialysis patients. Our aim was to evaluate both elimination of NTproBNP through dialysate and a possible relationship between plasma and/or dialysate NTproBNP level and membrane transport status of peritoneal dialysis patients.
  
  
  METHODS
  57 plasma (P) and dialysate (D) samples of 44 peritoneal dialysis (PD) patients were analyzed for NTproBNP. Modified peritoneal equilibration test (PET) results and other variables were obtained from the charts.
  
  
  RESULTS
  Median (IQR) NTproBNP concentrations (pg/mL × 1,000) in P and D were 3.3 (1 - 13) and 0.5 (0.2 - 3.6), respectively. There was a linear correlation between P-NTproBNP and D-NTproBNP (r = 0.928, p = 0.0001; regression equation was y = 0.897*x -0.28). Mean P/D-NTproBNP ratio was 5.5 ± 0.5. Median P and D-NTproBNP levels by the membrane transport status were aligned as high (H) > high average (HA) > low average (LA), and the difference between H and LA was statistically significant (p < 0.001). Mean arterial pressure (MAP), residual Kt/V and dialysate/plasma ratio of crearinine (D/P Cr) were significant predictors of D-NTproBNP; whereas only MAP and residual Kt/V were significant predictors of P-NTproBNP in multiple regression analysis. Both P- and D-NTproBNP have significant and similar size of correlations with MAP, albumin, D/P Cr ratio, and Na.
  
  
  CONCLUSIONS
  D-NTproBNP level is ~ 1/5 of P-NTproBNP, and the issue of relationship between membrane transport status and natriuretic peptide levels needs more work.
authors.forename: Suleyman
authors.initials: S
authors.lastname: Koz
authors.forename: Idris
authors.initials: I
authors.lastname: Sahin
authors.forename: Ismail
authors.initials: I
authors.lastname: Temel
authors.forename: Sema T
authors.initials: ST
authors.lastname: Koz
authors.forename: Zafer
authors.initials: Z
authors.lastname: Terzi
mesh_terms: D000328:Adult; D062186:Arterial Pressure; D001692:Biological Transport; D003404:Creatinine / Q000032:analysis; D015314:Dialysis Solutions / Q000737:chemistry*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000628:therapy*; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000032:analysis / Q000097:blood*; D010446:Peptide Fragments / Q000032:analysis / Q000097:blood*; D010530:Peritoneal Dialysis / Q000295:instrumentation*; D010537:Peritoneum / Q000378:metabolism; D012709:Serum Albumin / Q000378:metabolism; D012964:Sodium / Q000097:blood
chemical_list: D015314:Dialysis Solutions; D008567:Membranes, Artificial; D010446:Peptide Fragments; D012709:Serum Albumin; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D012964:Sodium; D003404:Creatinine