J 2013

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

LUDKA, Ondřej, Jindřich ŠPINAR, Josef TOMANDL and Tomas KONECNY

Basic information

Original name

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

Authors

LUDKA, Ondřej (203 Czech Republic, guarantor, belonging to the institution), Jindřich ŠPINAR (203 Czech Republic, belonging to the institution), Josef TOMANDL (203 Czech Republic, belonging to the institution) and Tomas KONECNY (203 Czech Republic)

Edition

Biomedical Papers of the Faculty of Medicine of Palacký University, Olomouc, Czech Republic, Olomouc, Palacký University, 2013, 1213-8118

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

Czech Republic

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 1.661

RIV identification code

RIV/00216224:14110/13:00071001

Organization unit

Faculty of Medicine

DOI

UT WoS

000329091500010

Keywords in English

Continuous ambulatory peritoneal dialysis; Ejection fraction; Hemodialysis; NT-proBNP

Tags

International impact, Reviewed
Změněno: 13/4/2014 11:46, Ing. Mgr. Věra Pospíšilíková

Abstract

V originále

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 NTproBNP 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.