Aminoterminal B-Type Natriuretic Peptide (NT-proBNP) in End-Stage Renal Failure Patients on Regular Hemodialysis: Does It Have Diagnostic and Prognostic Implications?

• Type: Article in International Scientific Journal
• Date: 2009

Authors

Pimenta J (Author) FMUP; Sampaio, F (Author) Other; Martins, P (Author) Other; Carvalho, B (Author) Other; Rocha Goncalves, F (Author) Other; Ferreira A (Author) FMUP; Bettencourt P (Author) FMUP

Journal

Title: Nephron - Clinical Practice

Vol. 111

Pages: C182-C188

ISSN: 1660-2110

Publisher: S. Karger AG

Indexing

ISI Web of Knowledge - 7 Citations

Scopus - 6 Citations

Scientific classification

FOS: Medical and Health sciences > Other medical sciences

Other information

Authenticus ID: P-003-REJ

DOI: 10.1159/000199458

Abstract (EN): Background: Amino-terminal B-type natriuretic peptide (NT-proBNP) quantification is a useful cardiovascular diagnostic and prognostic test. In renal failure its use may have constraints, as it depends on renal clearance. We aimed to evaluate the clinical usefulness of NT-proBNP in hemodialysis (HD) patients. Methods: We measured NT-proBNP levels in 44 patients before and after a regular high-flux HD. Cardiac parameters were evaluated by echocardiography. Patients were followed up for 656.5 +/- 476.4 days for the occurrence of hospital admission or death. Results: NT-proBNP levels decreased after HD (p < 0.0001) without correlation with ultrafiltration volume, Kt/V index, weight decrease or pulse pressure decrease. Pre- and post-HD NT-proBNP were similar in patients with and without left ventricular hypertrophy. Pre- HD levels were not significantly associated with prognosis, probably due to a type 2 error; post-HD NT-proBNP and NT-proBNP reduction ratio (RR) were predictive of the outcome by Kaplan-Meier analysis, but only RR remained associated with prognosis on multivariate regression analysis (hazard ratio 0.96; 95% confidence interval 0.93-0.99). Conclusion: Our results do not support the use of NT-proBNP in the diagnosis of left ventricular hypertrophy or volume status in HD patients, but suggest its utility in prognostic stratification. HD-related variation in NT-proBNP was associated with prognosis. Copyright (C) 2009 S. Karger AG, Basel

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 7