The Association between Volume Status and Plasma Brain Natriuretic Peptide in Hemodialysis Patients.
- Author:
Moo Yong PARK
1
;
Soo Jeong CHOI
;
Jin Kuk KIM
;
Seung Duk HWANG
Author Information
1. Department of Internal Medicine, Soon Chun Hyang University College of Medicine, Bucheon, Korea. sd7hwang@schbc.ac.kr
- Publication Type:Original Article
- Keywords:
Brain natriuretic peptide;
Hemodialysis;
Volume status
- MeSH:
Adult;
Blood Pressure;
Brain*;
Dilatation;
Echocardiography;
Estrogens, Conjugated (USP);
Humans;
Hypertrophy, Left Ventricular;
Natriuretic Peptide, Brain*;
Plasma*;
Renal Dialysis*;
Thorax;
Ultrafiltration;
Weight Gain
- From:Korean Journal of Nephrology
2006;25(2):273-281
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGOUND: Brain natriuretic peptide (BNP, b-type natriuretic peptide) is released into circulation in response to ventricular dilatation and pressure overload. In the general population, the plasma concentration of BNP are useful to predict left ventricular hypertrophy (LVH) and LV systolic dysfunction. Whether these cardiac hormone have correlation with hydration state in hemodialysis (HD) patients is unclear. METHODS: We measured the pre-HD and post-HD plasma BNP level in 36 HD patients and evaluated their cardiac state with echocardiography and their fluid overload state with chest X-ray. We checked intradialytic HD weight gain and ultrafiltration volume, as a marker of hydration status. RESULTS: Mean pre-HD BNP level of 36 HD patients was 545.79 pg/mL and mean post-HD BNP level was 503.64 pg/mL. And mean BNP level of 10 healthy adults was 13.46 pg/mL. In 29 patients, BNP level was decreased after HD. But BNP levels of 7 patients were paradoxically increased after HD. Ultrafiltration volume was smaller in these patients (p=0.03) and post-HD blood pressure was higher (p=0.048). Plasma BNP level was significantly increased in 17 patients with pulmonary congestion or cadiomegaly (p=0.005). But pre-HD BNP level did not correlated with pre-HD blood pressure. BNP reduction ratio was higher in larger ultrafiltration (UF) volume (>3 L) group than in smaller UF volume group (p=0.02). There were no difference in BNP levels between DM and non-DM group. CONCLUSION: Plasma BNP level seems to be a limited but useful, marker of volume status in HD patients.
