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Daily dialyses decrease plasma levels of brain natriuretic peptide (BNP), a biomarker of left ventricular dysfunction.
Hemodial Int. 2006 Oct; 10(4):394-8.HI

Abstract

Brain natriuretic peptide or B-type natriuretic peptide (BNP) is a sensitive marker of heart disease. Plasma levels of BNP increase in left ventricular failure and determination of plasma BNP has become a useful tool in the diagnosis of heart failure. Hemodialysis (HD) patients may have elevated plasma levels of BNP, particularly predialysis, that correlate with echocardiographic signs of left ventricular dysfunction. High BNP levels are also a strong predictor of mortality in both nonrenal and HD patients. We studied plasma BNP levels in patients who changed from conventional thrice-weekly dialysis to daily dialysis 6 times a week while maintaining a total weekly time on dialysis of 12 hr. Twelve HD patients, mean age 55 years, had 4 hr of conventional thrice-weekly treatment for 4 weeks. Predialysis and postdialysis blood samples were obtained at the last dialysis. Patients were then dialyzed for 2 hr, 6 times weekly, for 4 weeks (daily dialysis). Again, predialysis and postdialysis blood samples were collected at the last HD. Brain natriuretic peptide plasma concentrations were determined by immunoradiometric assay. Predialysis BNP levels decreased from 194+/-51 ng/L (68+/-19 pmol/L; mean+SE) during thrice-weekly HD to 113+/-45 ng/L (41+/-18 pmol/L; p = 0.001) after 4 weeks on daily dialysis. With thrice-weekly HD, predialysis BNP levels were higher than postdialysis levels: 120+/-26 ng/L (39+/-8 pmol/L; p = 0.059). With daily dialysis, predialysis BNP levels did not differ significantly from postdialysis levels. Elevated predialysis plasma levels of BNP, considered sensitive and early markers of left ventricular dysfunction, decreased when patients were changed from conventional thrice-weekly HD to daily dialysis maintaining total hours of dialysis per week constant. Given the accumulated evidence that BNP is a biomarker of left ventricular dysfunction and can be used for risk stratification and guidance in pharmacotherapy of heart failure, daily dialysis appears to lead to less cardiac distress.

Authors+Show Affiliations

Division of Nephrology, Karolinska University Hospital, Stockholm, Sweden. ingegerd.odar-cederlof@karolinska.seNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Controlled Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17014518

Citation

Odar-Cederlöf, Ingegerd, et al. "Daily Dialyses Decrease Plasma Levels of Brain Natriuretic Peptide (BNP), a Biomarker of Left Ventricular Dysfunction." Hemodialysis International. International Symposium On Home Hemodialysis, vol. 10, no. 4, 2006, pp. 394-8.
Odar-Cederlöf I, Bjellerup P, Williams A, et al. Daily dialyses decrease plasma levels of brain natriuretic peptide (BNP), a biomarker of left ventricular dysfunction. Hemodial Int. 2006;10(4):394-8.
Odar-Cederlöf, I., Bjellerup, P., Williams, A., Blagg, C. R., Twardowski, Z., Ting, G., & Kjellstrand, C. M. (2006). Daily dialyses decrease plasma levels of brain natriuretic peptide (BNP), a biomarker of left ventricular dysfunction. Hemodialysis International. International Symposium On Home Hemodialysis, 10(4), 394-8.
Odar-Cederlöf I, et al. Daily Dialyses Decrease Plasma Levels of Brain Natriuretic Peptide (BNP), a Biomarker of Left Ventricular Dysfunction. Hemodial Int. 2006;10(4):394-8. PubMed PMID: 17014518.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Daily dialyses decrease plasma levels of brain natriuretic peptide (BNP), a biomarker of left ventricular dysfunction. AU - Odar-Cederlöf,Ingegerd, AU - Bjellerup,Per, AU - Williams,Amy, AU - Blagg,Christopher R, AU - Twardowski,Zbylut, AU - Ting,George, AU - Kjellstrand,Carl M, PY - 2006/10/4/pubmed PY - 2006/12/9/medline PY - 2006/10/4/entrez SP - 394 EP - 8 JF - Hemodialysis international. International Symposium on Home Hemodialysis JO - Hemodial Int VL - 10 IS - 4 N2 - Brain natriuretic peptide or B-type natriuretic peptide (BNP) is a sensitive marker of heart disease. Plasma levels of BNP increase in left ventricular failure and determination of plasma BNP has become a useful tool in the diagnosis of heart failure. Hemodialysis (HD) patients may have elevated plasma levels of BNP, particularly predialysis, that correlate with echocardiographic signs of left ventricular dysfunction. High BNP levels are also a strong predictor of mortality in both nonrenal and HD patients. We studied plasma BNP levels in patients who changed from conventional thrice-weekly dialysis to daily dialysis 6 times a week while maintaining a total weekly time on dialysis of 12 hr. Twelve HD patients, mean age 55 years, had 4 hr of conventional thrice-weekly treatment for 4 weeks. Predialysis and postdialysis blood samples were obtained at the last dialysis. Patients were then dialyzed for 2 hr, 6 times weekly, for 4 weeks (daily dialysis). Again, predialysis and postdialysis blood samples were collected at the last HD. Brain natriuretic peptide plasma concentrations were determined by immunoradiometric assay. Predialysis BNP levels decreased from 194+/-51 ng/L (68+/-19 pmol/L; mean+SE) during thrice-weekly HD to 113+/-45 ng/L (41+/-18 pmol/L; p = 0.001) after 4 weeks on daily dialysis. With thrice-weekly HD, predialysis BNP levels were higher than postdialysis levels: 120+/-26 ng/L (39+/-8 pmol/L; p = 0.059). With daily dialysis, predialysis BNP levels did not differ significantly from postdialysis levels. Elevated predialysis plasma levels of BNP, considered sensitive and early markers of left ventricular dysfunction, decreased when patients were changed from conventional thrice-weekly HD to daily dialysis maintaining total hours of dialysis per week constant. Given the accumulated evidence that BNP is a biomarker of left ventricular dysfunction and can be used for risk stratification and guidance in pharmacotherapy of heart failure, daily dialysis appears to lead to less cardiac distress. SN - 1492-7535 UR - https://www.unboundmedicine.com/medline/citation/17014518/Daily_dialyses_decrease_plasma_levels_of_brain_natriuretic_peptide__BNP__a_biomarker_of_left_ventricular_dysfunction_ L2 - https://doi.org/10.1111/j.1542-4758.2006.00136.x DB - PRIME DP - Unbound Medicine ER -