The role of Brain Natriuretic Peptide in evaluating Left Ventricle function among patient with chronic renal failure on maintenance hemodialysis: the impact of body mass index

Abstract

Both chronic renal failure (CRF) and heart failure (HF) can predispose to pressure load or volume overload with subsequent elevation of serum brain natriuretic peptide (BNP) levels. This study tends to evaluate the role of BNP as a predictor of left ventricular function among patient with chronic renal failure on maintenance hemodialysis. Methods: This is a perspective cross-sectional study, including 89 (45 males and 44 females) patients on maintenance hemodialysis followed up for six months. BNP level, glomerular filtration and body mass index of the patients were measured and left ventricular function (EF%) was detected by echocardiography at the start of the study and after three and six months between October 2016 and April 2017.Results:Of 89 patients, 13 were underweight, 56 had a healthy weight, and 20 were overweight. There was a significant negative association between BNP level and both EF% and BMI (P<0.001, P<0.001) respectively. During the follow up of these patients there was a clear trend for BNP to be higher among patients with impaired left the ventricular function. 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%, BMI and GFR in patients with CRF. Currently, BNP widely used by most health institutions to predict left ventricular function. However, both BMI and GFR considered a significant confounder of BNP measurement in patients with compromised renal status.