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Comparison of NT-proBNP levels in hemodialysis versus peritoneal dialysis patients.

Abstract

BACKGROUND

Plasma N-terminal fragment of pro brain natriuretic peptide (NT-proBNP) concentration is elevated in cardiovascular diseases such as congestive heart failure, where increased levels of NT-proBNP indicate cardiac dysfunction, hypervolemia, and higher risk of hospitalization and death. These associations apply also to patients with severe impairment of kidney function. Little is known about diferences in plasma level of NT-proBNP in patients receiving hemodialysis (HD) versus those receiving continuous ambulatory peritoneal dialysis (CAPD).

AIM

To evaluate differences in plasma NT-proBNP concentration between HD and CAPD patients.

METHODS

Plasma NT-proBNP concentration was prospectively measured in consecutive patients receiving either HD or CAPD at our hospital center. All other standard clinical parameters were recorded. The correlation between plasma NT-proBNP concentration and the type of dialysis was then examined.

RESULTS

We studied 99 consecutive patients on HD (age 62 ± 15 years, 66% male) and 18 consecutive patients on CAPD (age 56 ± 18 years, 67% male). Both groups had similar baseline characteristics including duration of dialysis, left ventricular function and mass, and cardiothoracic ratio. Significantly more patients on HD had abnormal NT-proBNP levels compared to patients on CAPD (97% vs 44%; P<0.0001), and this difference remained highly significant when using various NT-proBNP cut off values. A subgroup analysis revealed that the lower NT-proBNP levels of CAPD patients are most pronounced in patients with preserved left ventricular ejection function. As expected, NT-proBNP levels correlated negatively with left ventricular function and positively with cardiothoracic ratio, and this applied to both HD and CAPD groups.

CONCLUSION

The lower concentration of NT-proBNP in patients on CAPD compared to those on HD suggests that CAPD produces lesser hemodynamic stress, especially in patients with preserved left ventricular systolic function. Even though increased NT-proBNP levels have been shown to predict increased morbidity and mortality, further studies are necessary to assess the long term benefit of CAPD compared to HD.

Authors+Show Affiliations

Internal Cardiology Department, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

23154540

Citation

Ludka, Ondrej, et al. "Comparison of NT-proBNP Levels in Hemodialysis Versus Peritoneal Dialysis Patients." Biomedical Papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia, vol. 157, no. 4, 2013, pp. 325-30.
Ludka O, Spinar J, Tomandl J, et al. Comparison of NT-proBNP levels in hemodialysis versus peritoneal dialysis patients. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2013;157(4):325-30.
Ludka, O., Spinar, J., Tomandl, J., & Konecny, T. (2013). Comparison of NT-proBNP levels in hemodialysis versus peritoneal dialysis patients. Biomedical Papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia, 157(4), 325-30. https://doi.org/10.5507/bp.2012.101
Ludka O, et al. Comparison of NT-proBNP Levels in Hemodialysis Versus Peritoneal Dialysis Patients. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2013;157(4):325-30. PubMed PMID: 23154540.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of NT-proBNP levels in hemodialysis versus peritoneal dialysis patients. AU - Ludka,Ondrej, AU - Spinar,Jindrich, AU - Tomandl,Josef, AU - Konecny,Tomas, Y1 - 2012/11/13/ PY - 2012/06/08/received PY - 2012/10/23/accepted PY - 2012/11/17/entrez PY - 2012/11/17/pubmed PY - 2015/4/7/medline SP - 325 EP - 30 JF - Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia JO - Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub VL - 157 IS - 4 N2 - BACKGROUND: Plasma N-terminal fragment of pro brain natriuretic peptide (NT-proBNP) concentration is elevated in cardiovascular diseases such as congestive heart failure, where increased levels of NT-proBNP indicate cardiac dysfunction, hypervolemia, and higher risk of hospitalization and death. These associations apply also to patients with severe impairment of kidney function. Little is known about diferences in plasma level of NT-proBNP in patients receiving hemodialysis (HD) versus those receiving continuous ambulatory peritoneal dialysis (CAPD). AIM: To evaluate differences in plasma NT-proBNP concentration between HD and CAPD patients. METHODS: Plasma NT-proBNP concentration was prospectively measured in consecutive patients receiving either HD or CAPD at our hospital center. All other standard clinical parameters were recorded. The correlation between plasma NT-proBNP concentration and the type of dialysis was then examined. RESULTS: We studied 99 consecutive patients on HD (age 62 ± 15 years, 66% male) and 18 consecutive patients on CAPD (age 56 ± 18 years, 67% male). Both groups had similar baseline characteristics including duration of dialysis, left ventricular function and mass, and cardiothoracic ratio. Significantly more patients on HD had abnormal NT-proBNP levels compared to patients on CAPD (97% vs 44%; P<0.0001), and this difference remained highly significant when using various NT-proBNP cut off values. A subgroup analysis revealed that the lower NT-proBNP levels of CAPD patients are most pronounced in patients with preserved left ventricular ejection function. As expected, NT-proBNP levels correlated negatively with left ventricular function and positively with cardiothoracic ratio, and this applied to both HD and CAPD groups. CONCLUSION: The lower concentration of NT-proBNP in patients on CAPD compared to those on HD suggests that CAPD produces lesser hemodynamic stress, especially in patients with preserved left ventricular systolic function. Even though increased NT-proBNP levels have been shown to predict increased morbidity and mortality, further studies are necessary to assess the long term benefit of CAPD compared to HD. SN - 1213-8118 UR - https://www.unboundmedicine.com/medline/citation/23154540/Comparison_of_NT_proBNP_levels_in_hemodialysis_versus_peritoneal_dialysis_patients_ L2 - http://biomed.papers.upol.cz/doi/10.5507/bp.2012.101.html DB - PRIME DP - Unbound Medicine ER -