Significance of atrial and brain natriuretic peptides in patients with diabetes mellitus undergoing hemodialysis

Ichikawa, Haruo; Nagake, Yoshio; Takahashi, Maki; Nakazono, Hiroshi; Kono, Kenji; Ogura, Toshio; Makino, Hírofumi

doi:10.1007/bf02480654

Cited by 4 publications

(7 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous reports have shown that post-HD levels of ANP and BNP are useful as parameter for volume status in HD patients without obvious cardiac disease [7,9,10,20,27]. Kuriyama et al [10] showed that the ideal post-HD ANP level was approximately 50-60 pg/ml, which was almost similar to that of patients without cardiac disease in our study.…”

Section: Discussionsupporting

confidence: 70%

“…Plasma was separated by centrifugation and stored at -70°C until analysis. ANP, BNP and cGMP were determined by available radioimmunoassay kits, namely Siono-RIA ANP and BNP (Shionogi, Osaka, Japan) [7] and Yamasa cGMP (Yamasa, Chiba, Japan) [25]. The intra-assay coefficients of variation for ANP, BNP and cGMP were 5.0, 5.6 and 5.2%, and the interassay coefficients of variation for ANP, BNP and cGMP were 5.8, 6.2 and 5.6%, respectively.…”

Section: Study Protocolmentioning

confidence: 99%

“…Significantly high plasma levels of atrial natriuretic peptide (ANP) [5][6][7][8][9][10], brain natriuretic peptide (BNP) [6][7][8]11] and cyclic guanosine monophosphate (cGMP) [12][13][14] have been reported in HD patients. These parameters have been used in the past to estimate DW, based on the evidence that they are correlated with volume changes in HD patients [2,7,8,10,[12][13][14].…”

Section: Introductionmentioning

confidence: 99%

“…These parameters have been used in the past to estimate DW, based on the evidence that they are correlated with volume changes in HD patients [2,7,8,10,[12][13][14]. In patients with CAD, plasma levels of ANP and BNP are higher than those in control subjects [15][16][17][18], and CAD induces a disproportionate rise in ANP and BNP release after volume loading [19].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Clinical Significance of Natriuretic Peptides and Cyclic GMP in Hemodialysis Patients with Coronary Artery Disease

et al. 2001

View full text Add to dashboard Cite

Background: Plasma concentrations of atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP) and cyclic guanosine monophosphate (cGMP) are suitable markers of ’dry body weight’ (DW) in hemodialysis (HD) patients. However, it is still unknown whether these markers can be applied to patients with renal failure and coronary artery disease (CAD). We examined the reliability of these peptides as volume markers in HD patients with CAD. We also assessed the relationship between natriuretic peptides and indices of left ventricular (LV) function. Methods: Plasma concentrations of ANP, BNP and cGMP were determined before and after HD in patients with CAD (group 1, n = 19, mean age 63 ± 12 years) and were compared with those of patients without cardiac disease (group 2, n = 20, age 61 ± 15 years). Using data obtained by cardiac catheterization, we examined the relationship between natriuretic peptides and indices of LV function in HD patients with CAD. Results: Baseline ANP (244 ± 205 pg/ml), BNP (713 ± 928 pg/ml) and cGMP (29.6 ± 21.6 pmol/ml) were significantly higher in group 1 than in 11 healthy volunteers (18.6 ± 9.9 pg/ml, 7.7 ± 7.6 pg/ml, cGMP 8.9 ± 4.9 pmol/ml, respectively). HD significantly reduced plasma ANP (87 ± 75 pg/ml) and BNP (477 ± 702 pg/ml) although they were still above normal control. HD reduced plasma cGMP (7.2 ± 4.5 pmol/ml) to normal values, suggesting the elimination of cGMP across the dialyzers. Baseline levels of ANP, BNP and cGMP in group 2 were less than those of group 1 but higher than the control. HD reduced natriuretic peptides in group 2 to levels lower than those in post-HD group 1. After HD, there was no significant correlation between reductions in body weight and changes in ANP or BNP. Baseline ANP and BNP levels closely correlated with pulmonary artery pressure, pulmonary artery wedge pressure, left ventricular end-diastolic pressure and left ventricular ejection fraction. A significant correlation was observed between BNP levels and the severity of CAD. Conclusion: ANP, BNP and cGMP seem to be a useful markers for fluid overload but not for DW in HD patients with CAD. Plasma ANP and BNP might be useful markers for left ventricular function.

show abstract

Section: Discussionsupporting

confidence: 70%

Section: Study Protocolmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Clinical Significance of Natriuretic Peptides and Cyclic GMP in Hemodialysis Patients with Coronary Artery Disease

et al. 2001

View full text Add to dashboard Cite

show abstract

“…Similarly, in end-stage renal disease patients treated with hemodialysis (HD), plasma levels of both peptides are markedly elevated [5][6][7][8][9][10][11]. It is well known that plasma ANP is an indicator of extracellular fluid volume expansion [12,13] and that it is considered to be a marker for determining the proper dry weight of HD patients.…”

Section: Introductionmentioning

confidence: 99%

The Prognostic Role of Brain Natriuretic Peptides in Hemodialysis Patients

et al. 2002

View full text Add to dashboard Cite

Background: Although plasma concentrations of brain natriuretic peptides (BNP) increase in hemodialysis (HD) patients as well as patients with cardiovascular diseases (CD), the clinical significance of BNP in HD patients has yet to be elucidated. In this study, we investigated the pathophysiological significance of BNP in HD patients. Methods: Plasma BNP concentrations were measured in 164 HD patients after HD and 14 healthy volunteers. In 12 patients without CD, BNP was also measured before HD. Multiple regression analysis was performed to determine the important factors causing increased plasma BNP concentrations. Cardiac mortality was monitored for 36 months after baseline analysis, and the prognostic role of BNP was examined by Cox proportional hazards regression analysis. Results: Plasma BNP concentrations of HD patients without CD decreased significantly during HD session (124.5 ± 90.7 vs. 91.4 ± 67.6 pg/ml, mean ± SD, p = 0.004), but were still significantly higher than those of the healthy subjects (9.7 ± 9.2 pg/ml, p = 0.0002). Plasma BNP concentrations of patients with CD were significantly higher than of those without CD (579.6 ± 564.3 vs. 204.0 ± 241.5 pg/ml, p < 0.0001). Plasma BNP concentrations were also significantly higher in diabetes mellitus (DM) patients than in non-DM patients (514.1 ± 585.4 vs. 296.0 ± 347.0 pg/ml, p = 0.0031). Multiple regression analysis showed that left ventricular mass index (LVMI), CD and DM were independent factors for the elevated BNP (R² = 0.303, p < 0.0001). During a 36-month follow-up period, cardiac death occurred in 13 patients. Kaplan-Meier survival estimates of patients from varying plasma BNP quartiles (<200, 200–450, 450–700 and >700 pg/ml) differed between the four groups (p < 0.0001). The group with the highest BNP level (>700 pg/ml) had the lowest survival. When compared with patients with BNP <200, the hazard ratios for cardiac death of patients with BNP of 200–450, 450–700 and >700 pg/ml were 2.3 [95% confidence interval (CI) 0.14–36.7], 18.7 (1.9–183.4) and 51.9 (6.5–416.3), respectively. The univariate Cox proportional hazards model showed that BNP, left ventricular ejection fraction, LVMI, age, DM, serum albumin and C-reactive protein (CRP) were significantly associated with the risk of cardiac mortality. By stepwise multivariate Cox proportional hazards analysis, only BNP, LVMI and CRP remained powerful independent predictors of cardiac death. The relative risk ratios were 1.002 (95% CI 1.001–1.002) for BNP, 2.192 (1.532–3.135) for CRP and 1.027 (1.013–1.042) for LVMI. Conclusion: High plasma BNP concentrations in HD patients were associated with volume overload, left ventricular hypertrophy, CD and DM. Plasma BNP concentration may be a useful parameter for assessing the risk of cardiac death in HD patients by providing prognostic information independently of other variables previously reported.

show abstract

Plasma Adrenomedullin Levels in Patients on Hemodialysis

Yamasaki

Nagake

Akagi

et al. 2001

Nephron

Self Cite

View full text Add to dashboard Cite

Adrenomedullin (AM) is a hypotensive peptide that has recently been isolated from human pheochromocytoma. In this study, we measured plasma AM concentrations in 54 patients on hemodialysis (HD) and examined the clinical significance. We also evaluated the effects of high-flux and low-flux dialysis membranes on plasma AM levels. The average value of plasma AM at pre-HD (4.44 ± 0.16 fmol/ml) was significantly elevated compared with that in 44 healthy volunteers (1.31 ± 1.41 fmol/ml) (p < 0.0001). The plasma AM concentrations at pre-HD showed a negative correlation with age and mean blood pressure (MBP) at pre-HD. The plasma AM concentrations at post-HD showed a negative correlation with MBP at post-HD and a negative correlation with the reduction rate of AM. Multiple regression analysis showed that age and MBP were independent factors associated with plasma AM at pre-HD and that MBP and reduction rate of AM were independent factors associated with plasma AM at post-HD. We investigated the differences between high-flux dialyzers (PS-UW, PS-N and FB-F) and a low-flux dialyzer (AM-BC-F), and we found that high-flux dialyzers removed plasma AM more efficiently than a low-flux dialyzer did. In addition, in 3 patients on HD, plasma AM levels decreased significantly during isovolumic dialysis using a high-flux dialyzer, despite the fact that there were no significant changes in MBP and ANP. In conclusion, elevation in plasma AM level causes a fall in MBP in patients on HD, therefore, removal of AM by HD treatment using a high-flux dialyzer contributes to the stability of blood pressure during HD.

show abstract

Significance of atrial and brain natriuretic peptides in patients with diabetes mellitus undergoing hemodialysis

Cited by 4 publications

References 25 publications

Clinical Significance of Natriuretic Peptides and Cyclic GMP in Hemodialysis Patients with Coronary Artery Disease

Clinical Significance of Natriuretic Peptides and Cyclic GMP in Hemodialysis Patients with Coronary Artery Disease

The Prognostic Role of Brain Natriuretic Peptides in Hemodialysis Patients

Plasma Adrenomedullin Levels in Patients on Hemodialysis

Contact Info

Product

Resources

About