N-terminal Pro-B-Type Natriuretic Peptide and Malnutrition in Patients on Hemodialysis

Larifla, Laurent; Merault, Henri; Galantine, Valérie; Bassien-Capsa, Valérie; Foucan, Lydia

doi:10.1155/2020/9528014

Cited by 6 publications

(5 citation statements)

References 62 publications

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“…25 Regarding the role of natriuretic peptides, previous studies have identified a potential association between these markers and malnutrition. [26][27][28][29] The association between high concentrations of natriuretic peptides and malnutrition is likely explained by their role as markers of congestion and hence gut oedema, malabsorption, and inflammatory activation. In the context of advanced HF, very-high levels of natriuretic peptides (i.e.…”

Section: Discussionmentioning

confidence: 99%

“…In particular, bioelectrical impedance analysis is useful to assess body composition, identify malnutrition and perform close and targeted patient monitoring 25 . Regarding the role of natriuretic peptides, previous studies have identified a potential association between these markers and malnutrition 26–29 . The association between high concentrations of natriuretic peptides and malnutrition is likely explained by their role as markers of congestion and hence gut oedema, malabsorption, and inflammatory activation.…”

Section: Discussionmentioning

confidence: 99%

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Impact of malnutrition in patients with severe heart failure

Pagnesi,

Serafini,

Chiarito

et al. 2024

European J of Heart Fail

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AimThe role of malnutrition among patients with severe heart failure (HF) is not well established. We evaluated the incidence, predictors, and prognostic impact of malnutrition in patients with severe HF.Methods and resultsNutritional status was measured using the geriatric nutritional risk index (GNRI), based on body weight, height and serum albumin concentration, with malnutrition defined as GNRI ≤98. It was assessed in consecutive patients with severe HF, defined by at least one high‐risk ‘I NEED HELP’ marker, enrolled at four Italian centres between January 2020 and November 2021. The primary endpoint was all‐cause mortality. A total of 510 patients with data regarding nutritional status were included in the study (mean age 74 ± 12 years, 66.5% male). Among them, 179 (35.1%) had GNRI ≤98 (malnutrition). At multivariable logistic regression, lower body mass index (BMI) and higher levels of natriuretic peptides (B‐type natriuretic peptide [BNP] > median value [685 pg/ml] or N‐terminal proBNP > median value [5775 pg/ml]) were independently associated with a higher likelihood of malnutrition. Estimated rates of all‐cause death at 1 year were 22.4% and 41.1% in patients without and with malnutrition, respectively (log‐rank p < 0.001). The impact of malnutrition on all‐cause mortality was confirmed after multivariable adjustment for relevant covariates (adjusted hazard ratio 2.03, 95% confidence interval 1.43–2.89, p < 0.001).ConclusionIn a contemporary, real‐world, multicentre cohort of patients with severe HF, malnutrition (defined as GNRI ≤98) was common and independently associated with an increased risk of mortality. Lower BMI and higher natriuretic peptides were identified as predictors of malnutrition in these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Impact of malnutrition in patients with severe heart failure

Pagnesi,

Serafini,

Chiarito

et al. 2024

European J of Heart Fail

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“…However, whether NT-proBNP is a marker of volume overload or a marker of left ventricular dysfunction remains unclear. A review article showed that NT-proBNP was correlated with PEW syndrome and inflammation in patients undergoing hemodialysis [28]. In fact, 63.8% of patients with NT-proBNP ≥7200 pg/mL had low SMI and/or inflammation, and 53 patients (66.3%) had low PhA and/or inflammation.…”

Section: Discussionmentioning

confidence: 99%

Associations between N-Terminal Pro-B-Type Natriuretic Peptide, Body Fluid Imbalance and Quality of Life in Patients Undergoing Hemodialysis: A Cross-Sectional Study

Yamazaki,

Ishii,

Hitaka

et al. 2023

JCM

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Natriuretic peptides may be associated with the complex interaction between malnutrition and fluid overload. This study assessed the relationship between N-terminal pro-B-type natriuretic peptide (NT-proBNP), body fluid composition, and quality of life (QOL) domains. A multicenter, cross-sectional study was conducted between 2019 and 2022. The QOL survey of 322 patients undergoing maintenance hemodialysis (227 men and 95 women; mean age, 65 ± 12 years) was conducted using the Kidney Disease QOL-Short Form v. 1.3. The patients in the higher NT-proBNP quartile group were older and had a longer dialysis vintage; lower body mass index, serum albumin, blood urea nitrogen, creatinine, sodium, uric acid, total cholesterol, triglycerides, and hemoglobin levels; lower geriatric nutritional risk index (GNRI), skeretal mascle mass index, and phase angle (PhA); and higher pre- and post-dialysis systolic blood pressure (BP), cardiothoracic index, and C-reactive protein (CRP) (p < 0.05). Multivariate analysis revealed that post-dialysis systolic BP, CRP, and GNRI or PhA were independently associated with NT-proBNP. The higher NT-proBNP group experienced muscle attenuation and/or inflammation and an enlarged left atrium. Consequently, the elevated NT-proBNP by such an imbalance in body fluid composition is associated with lower health-related QOL.

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“…NT-proBNP is mainly cleared through glomerular filtration by the kidney, which explains the strong correlation between renal function and NT-proBNP levels [ 9 ]. In patients with CKD, besides heart and renal failure, other factors, such as hyperhydration, left ventricular hypertrophy, anemia [ 3 , 10 ], age, inflammation, and malnutrition, can increase the levels of NT-proBNP [ 11 , 12 , 13 , 14 , 15 ]. In these patients, the ratio between the cardiac secretion of NT-proBNP linked to different stimuli and the retention of NT-proBNP due to renal dysfunction is unknown [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

N-Terminal Pro-Brain Natriuretic Peptide Correlates with Ghrelin and Acyl-Ghrelin in Pre-Dialysis Chronic Kidney Disease

Rusu,

Anton,

Valea

et al. 2024

IJMS

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Pro-B amino-terminal natriuretic peptide (NT-proBNP) is a diagnostic marker for heart failure (HF), a severe complication of chronic kidney disease (CKD). However, its significance in CKD is not clear, as other factors, such as renal function, may also have an impact. Recent studies have shown that ghrelin treatment is effective in HF in the general population, but the impact of ghrelin on cardiac function in CKD patients is still unknown. Our study aimed to investigate the factors associated with NT-proBNP in pre-dialysis CKD patients and to evaluate the correlation between NT-proBNP and ghrelin and acyl-ghrelin, molecules determined using ELISA methods. In a cross-sectional observational study, we included 80 patients with pre-dialysis CKD, with a mean age of 68 years and 50% men. The median values for NT-proBNP were 351.8 pg/mL, for acyl ghrelin 16.39 pg/mL, and for ghrelin 543.32 pg/mL. NT-proBNP was correlated with ghrelin (p = 0.034, r = 0.24), acyl-ghrelin (p = 0.033, r = −0.24), estimated glomerular filtration rate (p = 0.027, r = −0.25), serum urea (p = 0.006, r = 0.31), and ferritin (p = 0.041, r = 0.28). In multivariate analysis, ghrelin (p = 0.040) and blood urea (p = 0.040) remained significant predictors for NT-proBNP levels. NT-proBNP was a significant predictor for acyl-ghrelin (p = 0.036). In conclusion, in pre-dialysis CKD patients, a high value of NT-proBNP was associated with a high value of total ghrelin and a low value of acyl-ghrelin.

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N-terminal Pro-B-Type Natriuretic Peptide and Malnutrition in Patients on Hemodialysis

Cited by 6 publications

References 62 publications

Impact of malnutrition in patients with severe heart failure

Impact of malnutrition in patients with severe heart failure

Associations between N-Terminal Pro-B-Type Natriuretic Peptide, Body Fluid Imbalance and Quality of Life in Patients Undergoing Hemodialysis: A Cross-Sectional Study

N-Terminal Pro-Brain Natriuretic Peptide Correlates with Ghrelin and Acyl-Ghrelin in Pre-Dialysis Chronic Kidney Disease

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