The Importance of Brain Natriuretic Peptide in Assessment Left Ventricle Function Among Patient with Chronic Kidney Disease on Maintenance Hemodialysis: The Impact of the Dialysis Session

Abstract

Background: chronic renal failure (CRF) characterized by increased plasma level of brain natriuretic peptide (BNP) due to increase peptide secretion and decrease BNP clearance due to impaired renal function. This peptide is a biomarker of cardiovascular disorders which are the common causes of morbidity and mortality in patients with CRF. The present study tend to evaluate the role of BNP as a predictor of left ventricular function among patient with chronic renal failure on maintenance hemodialysis(HD) with particular concern to dialysis session frequency. Methods: A total of 90 patients with CRF who visited the dialysis unit at Al-Hussein Teaching Hospital in Thi-Qar city for maintenance hemodialysis were included in this study. They were divided into three groups according to the number of dialysis session per week. BNP level, glomerular filtration rate(GFR) of the patients were measured and left ventricular function (EF%) was detected by echocardiography. Results: There was a significant negative association between BNP level and EF% (P<0.001). BNP level was significantly lower in patients with three dialysis session per week in comparison with those patients who perform single session per week (P <0.001). There was also a strong inverse association between BNP level and GFR (P <0.001).Conclusion: BNP levels show a strong inverse association with EF% and GFR in patients with CRF. Patients with frequent dialysis had better left ventricular function manifested by lower BNP level and higher EF% than those patients with less frequent dialysis session.