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Aminoterminal B-type natriuretic peptide (NT-proBNP) in end-stage renal failure patients on regular hemodialysis: does it have diagnostic and prognostic implications?
Nephron Clin Pract. 2009; 111(3):c182-8.NC

Abstract

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.

Authors+Show Affiliations

Internal Medicine Department, Hospital S. João, Porto, Portugal. joanapimenta@clix.ptNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19194108

Citation

Pimenta, Joana, et al. "Aminoterminal B-type Natriuretic Peptide (NT-proBNP) in End-stage Renal Failure Patients On Regular Hemodialysis: Does It Have Diagnostic and Prognostic Implications?" Nephron. Clinical Practice, vol. 111, no. 3, 2009, pp. c182-8.
Pimenta J, Sampaio F, Martins P, et al. Aminoterminal B-type natriuretic peptide (NT-proBNP) in end-stage renal failure patients on regular hemodialysis: does it have diagnostic and prognostic implications? Nephron Clin Pract. 2009;111(3):c182-8.
Pimenta, J., Sampaio, F., Martins, P., Carvalho, B., Rocha-Gonçalves, F., Ferreira, A., & Bettencourt, P. (2009). Aminoterminal B-type natriuretic peptide (NT-proBNP) in end-stage renal failure patients on regular hemodialysis: does it have diagnostic and prognostic implications? Nephron. Clinical Practice, 111(3), c182-8. https://doi.org/10.1159/000199458
Pimenta J, et al. Aminoterminal B-type Natriuretic Peptide (NT-proBNP) in End-stage Renal Failure Patients On Regular Hemodialysis: Does It Have Diagnostic and Prognostic Implications. Nephron Clin Pract. 2009;111(3):c182-8. PubMed PMID: 19194108.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Aminoterminal B-type natriuretic peptide (NT-proBNP) in end-stage renal failure patients on regular hemodialysis: does it have diagnostic and prognostic implications? AU - Pimenta,Joana, AU - Sampaio,Francisco, AU - Martins,Patrícia, AU - Carvalho,Berta, AU - Rocha-Gonçalves,Francisco, AU - Ferreira,António, AU - Bettencourt,Paulo, Y1 - 2009/02/05/ PY - 2007/07/26/received PY - 2008/09/25/accepted PY - 2009/2/6/entrez PY - 2009/2/6/pubmed PY - 2009/12/16/medline SP - c182 EP - 8 JF - Nephron. Clinical practice JO - Nephron Clin Pract VL - 111 IS - 3 N2 - 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. SN - 1660-2110 UR - https://www.unboundmedicine.com/medline/citation/19194108/Aminoterminal_B_type_natriuretic_peptide__NT_proBNP__in_end_stage_renal_failure_patients_on_regular_hemodialysis:_does_it_have_diagnostic_and_prognostic_implications L2 - https://www.karger.com?DOI=10.1159/000199458 DB - PRIME DP - Unbound Medicine ER -