B‐type natriuretic peptide is a useful biomarker for the estimation of volume overload in children with hypertension on peritoneal dialysis

Lee, Joo Hoon

doi:10.1111/nep.13241

Cited by 11 publications

(7 citation statements)

References 19 publications

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“…In this study, BNP elevation was associated with increased LVIDs, LVIDd, LVCO, LVSV, LVESV, and LVEDV. We have previously reported that increased BNP was associated with fluid retention in hypertensive children on PD (6). Fluid retention results in increased preload and afterload (28).…”

Section: Discussionmentioning

confidence: 96%

“…Second, LVH is usually caused by hypertension (27). The most important cause of hypertension in PD patients is chronic fluid retention, and serum BNP levels are a good biomarker to assess the volume overload (6). However, there are factors besides fluid overload, such as increased activity of various vasoactive substances, renin-angiotensin system, and sympathetic nervous system (6).…”

Section: Discussionmentioning

confidence: 99%

“…In patients with end-stage renal disease (ESRD), the interpretation of BNP remains unclear because serum BNP concentrations may depend on not only cardiac function and dimensions but also renal function, fluid volume, and dialysis clearance (2). We have recently published that BNP is a useful biomarker of fluid retention in hypertensive children on peritoneal dialysis (PD) (6). In this study, we evaluated in detail the association of BNP levels with morphological and functional changes in various cardiac parameters using echocardiography in children with ESRD who were on PD.…”

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confidence: 99%

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B-Type Natriuretic Peptide Levels and Cardiac Dysfunction in Children on Peritoneal Dialysis

Baek

Kim

et al. 2019

Perit Dial Int

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Background Abnormalities in left ventricular (LV) structure and function are prevalent in patients on peritoneal dialysis (PD). The risk of cardiovascular mortality is also 10 – 20 times higher in PD patients than in age- and gender-matched healthy control subjects. Methods Echocardiography was performed annually or every 6 months for children on PD; the frequency was increased if the patient had hypertension or any heart problem. We retrospectively reviewed echocardiographic findings of these children (since February 2005) by chart review. The linear regression analysis of log(B-type natriuretic peptide, BNP) was performed to evaluate the association between serum BNP and cardiac parameters on echocardiography. Results We enrolled 52 patients and evaluated 169 echocardiographic findings in association with serum BNP levels. Systolic blood pressure (adjusted R2 = 0.321), diastolic blood pressure (adjusted R2 = 0.292), LV posterior wall thickness at diastole (0.058), LV posterior wall thickness at systole (0.038), LV internal diameter at diastole (0.177), LV internal diameter at systole (0.132), LV mass index (0.122), thickness of interventricular septum at diastole (0.035), the left atrial (LA) diameter (0.201), LA/aorta diameter ratio (0.113), lateral E/E’ (0.229), and lateral A'/E’ (0.149) showed positive correlation with log(BNP); conversely, LV fractional shortening (FS) (0.065), LV ejection fraction (0.082), right ventricular internal diameter at diastole (0.184), right ventricular fractional shortening (0.754), lateral S’ (0.179), and lateral E’ (0.161) showed negative correlation with log(BNP). Conclusions Routine measurement of serum BNP is recommended in children on PD to evaluate the risk of morphological and functional cardiac problems.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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B-Type Natriuretic Peptide Levels and Cardiac Dysfunction in Children on Peritoneal Dialysis

Baek

Kim

et al. 2019

Perit Dial Int

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“…There are no reliable biomarkers in blood for detecting intra- or extravascular fluid overload [57–60]. Some biomarkers like plasma B-type natriuretic peptide, urine cystatin C and urine neutrophil gelatinase-associated lipocalin are related to intravascular volume and/or fluid overload in children with kidney failure after cardiac surgery [39 ▪ ].…”

Section: Evaluation Of Fluid Overloadmentioning

confidence: 99%

Evaluating fluid overload in critically ill children

Bem,

Lemson

2024

Current Opinion in Pediatrics

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Purpose of review To review the evaluation and management of fluid overload in critically ill children. Recent findings Emerging evidence associates fluid overload, i.e. having a positive cumulative fluid balance, with adverse outcome in critically ill children. This is most likely the result of impaired organ function due to increased extravascular water content. The combination of a number of parameters, including physical, laboratory and radiographic markers, may aid the clinician in monitoring and quantifying fluid status, but all have important limitations, in particular to discriminate between intra- and extravascular water volume. Current guidelines advocate a restrictive fluid management, initiated early during the disease course, but are hampered by the lack of high quality evidence. Summary Recent advances in early evaluation of fluid status and (tailored) restrictive fluid management in critically ill children may decrease complications of fluid overload, potentially improving outcome. Further clinical trials are necessary to provide the clinician with solid recommendations.

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“…With respect to blood pressure variation, in the largest study of pediatric peritoneal dialysis patients with hypertension, change in BNP correlated strongly with change in systolic blood pressure and change in diastolic blood pressure [ 17 ].…”

Section: Pediatric Implicationsmentioning

confidence: 99%

Assessment of fluid status in neonatal dialysis: the need for new tools

Nourbakhsh

Benador

2022

Pediatr Nephrol

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Background Assessment of fluid status in neonatal dialysis has largely focused on traditional tools including clinical assessment, serial weights, and blood pressure (BP) measurements. However, in infants on kidney replacement therapy, the assessment of fluid overload is problematic due to errors in weight assessment, subtlety of physical exam findings, and inaccuracy of non-invasive BP measurements. Case summary In this presentation of a neonate with bilateral renal agenesis requiring kidney replacement therapy, the treating team assessed a number of variables in determining the ultrafiltration prescription for dialysis across 2 modalities (hemodialysis and continuous kidney replacement therapy). Complications Fluid overload, cardiomegaly, and worsened respiratory status occurred when attempting to assess the neonate’s fluid status by traditional markers (weights, blood pressures, physical exam findings). B-type natriuretic peptide (BNP) was obtained and was noted to correlate with the degree of fluid overload. Key management points Compared to traditional tools for assessment of fluid status in pediatric dialysis, BNP assisted the medical team in optimizing the volume status of the subject and determining optimal daily ultrafiltration goals. Due to the rapid release in response to myocardial stretch and the lack of kidney clearance of the peptide, BNP may represent an objective, timely, and reliable index of volume status in the pediatric dialysis patient.

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B‐type natriuretic peptide is a useful biomarker for the estimation of volume overload in children with hypertension on peritoneal dialysis

Abstract: We should measure BNP in hypertensive patients on PD to evaluate the volume status.

Cited by 11 publications

References 19 publications

B-Type Natriuretic Peptide Levels and Cardiac Dysfunction in Children on Peritoneal Dialysis

B-Type Natriuretic Peptide Levels and Cardiac Dysfunction in Children on Peritoneal Dialysis

Evaluating fluid overload in critically ill children

Assessment of fluid status in neonatal dialysis: the need for new tools

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