Is N-terminal probrain-type natriuretic peptide a clinically useful biomarker of volume overload in peritoneal dialysis patients?

Papakrivopoulou, Eugenia; Lillywhite, Samuel; Davenport, Andrew

doi:10.1093/ndt/gfr338

Cited by 52 publications

(49 citation statements)

References 21 publications

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“…Our cohort was a group of stable outpatient attenders, with median C-reactive protein concentration in the normal reference range, and this may account for the loss of effect of serum C-reactive protein and albumin compared to other studies [24], as the greatest effect on BNP comes from studies following hospital admissions in haemodialysis patients admitted with acute illnesses [25]. However, the strongest association was with post-dialysis ECW/TBW, although there were also other associations with post-dialysis haemoglobin, ultrafiltration rate, and mean arterial blood pressure.…”

Section: Discussionmentioning

confidence: 99%

Is There a Role for N-Terminal Probrain-Type Natriuretic Peptide in Determining Volume Status in Haemodialysis Patients?

Kumar¹,

Khosravi²,

Massart³

et al. 2013

Nephron Clin Pract

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Background/Aims: Natriuretic peptides have been reported to be a valuable biomarker for predicting cardiac events and mortality for haemodialysis patients. However, there has been a debate as to whether these biomarkers can be used to assess volume overload and help determine dry weight. Methods: We measured the N-terminal probrain natriuretic peptide (NTproBNP) in 366 stable haemodialysis outpatients with a corresponding pre- and post-dialysis multifrequency bioimpedance assessment of extracellular water (ECW)/total body water (TBW). Results: Median age was 61 years (46–73); 58.5% were male, 28.5% diabetic, and 37.7% Caucasoid; 71.1% had a history of hypertension, 8.4% of myocardial infarction, and 9.3% of coronary artery bypass surgery; dialysis vintage was 54 months (22–85.5), and urea reduction ratio was 73.4 ± 7.6%. Median post-dialysis NTproBNP was 179 pmol/l (68–535), pre-dialysis ECW/TBW was 0.393 ± 0.014, and post-dialysis ECW/TBW was 0.385 ± 0.015. On multivariate analysis log NTproBNP was associated with post-dialysis ECW/TBW (β 9.09, 95% CI 3.22–14.95, p = 0.003), mean arterial pressure (β 0.0087, 95% CI –0.0045 to –0.013, p = 0.000), and ultrafiltration rate (ml/kg· h; β 0.038, 95% CI 0.01–0.06, p = 0.001). Conclusion: In this study postdialysis NTproBNP values were correlated with direct assessments of volume status in haemodialysis patients, i.e. by ECW/TBW, or indirect measures of volume overload, i.e. ultrafiltration rate and post-dialysis mean arterial blood pressure. This suggests that serial NTproBNP values may aid clinical assessments of volume status in dialysis patients.

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Section: Discussionmentioning

confidence: 99%

Is There a Role for N-Terminal Probrain-Type Natriuretic Peptide in Determining Volume Status in Haemodialysis Patients?

Kumar¹,

Khosravi²,

Massart³

et al. 2013

Nephron Clin Pract

View full text Add to dashboard Cite

show abstract

“…Additionally, FIGURE 2 presents the Kaplan-Meier curves plotted for the subgroups according to changes in NT-proBNP levels, which were strongly in favor of improved survival in the "decrease" and "stable low" groups. The multivariate Cox proportional hazard regression analysis revealed Papakrivopoulou et al, 24 and Yilmaz et al 26 found substantial correlations between natriuretic peptides and blood pressure. In our study, apart from OH, NT-proBNP was also associated with PRDD, which is not surprising because residual renal function strongly affects NT-proBNP clearance.…”

Section: Discussionmentioning

confidence: 95%

“…These findings are, at least partially, in line with other studies. 20,24,25,31,32 On the other hand, Booth et al 21 was able to connect log NT-proBNP with ultrafiltration rate, whereas Nongnuch et al, …”

Section: -32mentioning

confidence: 99%

“…22 In general, hemoglobin, albumin, BMI, and FTI were negatively correlated with NT-proBNP, which is in accordance with observations from other studies. 24,[29][30][31] Intrestingly, the comparisons and correlations for CRP showed no significant results. Although a few studies support our findings, 18,24 the vast majority of investigators managed to connect the inflammatory status with NT-proBNP.…”

Section: Acknowledgmentsmentioning

confidence: 99%

See 1 more Smart Citation

N‑terminal pro‑B-type natriuretic peptide as a marker of hypervolemia and predictor of increased mortality in patients on hemodialysis

Schwermer¹,

Hoppe²,

Radziszewska³

et al. 2015

Polish Archives of Internal Medicine

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“…8 Besides clinical findings (blood pressure, presence of edema, and weight gain), echocardiography, Dual Energy X-ray Absorptiometry (DEXA), direct measurement of extracellular and total body water (TBW), brain natriuretic peptide (BNP) has been used for the determination of hydration status. 9 None of these methods are perfect, each having either clinical or financial limitations. Clinical findings may be misleading as vascular stiffness and cardiac dysfunction may confuse the status by affecting blood pressure.…”

Section: Introductionmentioning

confidence: 99%

Volume Status in Patients on Peritoneal Dialysis: The Role of Apelin and Bio-Impedance Spectroscopy

et al. 2012

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One of the main factors determining the survival of peritoneal dialysis (PD) patients is volume status. We aimed to investigate hydration status of PD patients by bio-impedance spectroscopy (BIS) and echocardiography and to study the relation of them with apelin, which has effects related with volume status like vasodilation, positive inotropism, and inhibition of ADH release and RAS antagonism. Chronic PD patients without active cardiac disease or clinically prominent hypervolemia were included. Besides the demographic, clinical, and laboratory data, BIS and echocardiographic findings together with apelin levels were recorded. The study included 21 patients. Of them, eight patients were euvolemic, one patient was hypovolemic, and others have some degree of overhydration (1.1-6.8 L) with BIS, although all were euvolemic clinically. Mean apelin level was 1.49 AE 0.49 ng/mL. Apelin level was positively correlated with ejection fraction and negatively with total body water (TBW), intracellular and extracellular water, lean tissue mass, and left atrium diameter. On linear regression model, TBW was the major determinant of apelin. Although apelin is expected to increase in hypervolemic patients, the negative correlation with body water in this study may be related with yet unknown role of apelin in dialyzed patients. They may have important roles in volume status in future.

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Is N-terminal probrain-type natriuretic peptide a clinically useful biomarker of volume overload in peritoneal dialysis patients?

Cited by 52 publications

References 21 publications

Is There a Role for N-Terminal Probrain-Type Natriuretic Peptide in Determining Volume Status in Haemodialysis Patients?

Is There a Role for N-Terminal Probrain-Type Natriuretic Peptide in Determining Volume Status in Haemodialysis Patients?

N‑terminal pro‑B-type natriuretic peptide as a marker of hypervolemia and predictor of increased mortality in patients on hemodialysis

Volume Status in Patients on Peritoneal Dialysis: The Role of Apelin and Bio-Impedance Spectroscopy

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