Nephron Clinical Practice

Original Paper

Brain Natriuretic Peptide and N-Terminal proBNP in Chronic Haemodialysis Patients

Racek J.a · Králová H.a · Trefil L.a · Rajdl D.a · Eiselt J.b

Author affiliations

aInstitute of Clinical Biochemistry and Haematology and b1st Department of Internal Medicine, Charles University Hospital, Pilsen, Czech Republic

Keywords: Brain natriuretic peptideN-terminal proBNPHaemodialysisHeart failure

Related Articles for ""
Nephron Clin Pract 2006;103:c162–c172
https://doi.org/10.1159/000092914

Log in to MyKarger to check if you already have access to this content.




Forgot your password
Sign up to MyKarger

Buy

  • FullText & PDF
  • Unlimited re-access via MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more
CHF 38.00 *
EUR 35.00 *
USD 39.00 *

Select

KAB

Buy a Karger Article Bundle (KAB) and profit from a discount!


If you would like to redeem your KAB credit, please log in.

Save over 20% compared to the individual article price.

Learn more

Rent/Cloud

  • Rent for 48h to view
  • Buy Cloud Access for unlimited viewing via different devices
  • Synchronizing in the ReadCube Cloud
  • Printing and saving restrictions apply
Rental: USD 8.50
Cloud: USD 20.00

Select

Subscribe

For eJournal Archive and eJournal Backfiles information please contact Karger service

* The final prices may differ from the prices shown due to specifics of VAT rules.

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: November 26, 2004
Accepted: December 30, 2005
Published online: May 26, 2006
Issue release date: July 2006

Number of Print Pages: 1
Number of Figures: 6
Number of Tables: 5


eISSN: 1660-2110 (Online)

For additional information: https://www.karger.com/NEC

Abstract

Background: Brain natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) are released into circulation as a result of congestive heart failure (HF). As HF and water overload are frequent complications in haemodialysis (HD) patients, we decided to study the levels of BNP and NT-proBNP and their changes during HD. Methods: BNP and NT-proBNP levels were determined in 94 HD patients before and after a regular 4-h HD. We followed changes in these peptides during HD depending on age, sex, HF (NYHA classification and left ventricular ejection fraction [LVEF]), duration on HD, presence of hypertension, coronary artery disease, type of membrane used for HD [low-flux (LFx) or high-flux (HFx)] and body mass change during HD. Furthermore, patients´ basic medication and creatinine levels and presence of diabetes mellitus were monitored. Results: Respectively,94% and 100% of the patients had pre-dialysis concentrations of BNP and NT-proBNP above the cut-off values for HF. The marker levels correlated significantly both before and after HD (r = 0.903 and 0.888, respectively, p < 0.001). BNP levels significantly decreased (p < 0.0001), whereas NT-proBNP significantly increased (p < 0.0001) during HD on LFx membranes. HD on HFx membranes caused greater decrease of BNP (compared to LFx membranes, p < 0.001), but also a decrease of NT-proBNP (p < 0.001).We did not find any significant differences in marker levels for HF and non-HF patients (NYHA classification). However, both peptides reached higher levels in the group with LVEF ≤50% (p < 0.001 for both peptides). Body mass change during HD negatively correlated only with the change of NT-proBNP (r = –0.27, p < 0.05). In the multiple regression model, the change of both peptides during HD was significantly influenced by membrane type (p = 0.003 for BNP and p = 0.001 for NT-proBNP). NT-proBNP change during HD was further significantly influenced by LVEF (p = 0.012), sex (p = 0.002) and duration on HD (p = 0.006). Conclusions: Both BNP and NT-proBNP levels were significantly increased in HD patients prior to dialysis. The change in concentrations of both peptides during HD is influenced by membrane type. HD probably triggers increased production of both peptides and this increase is emphasized by impaired LVEF. This fact can be clinically observed only on NT-proBNP levels, because BNP levels are biased by significant removal of this protein during HD.

© 2006 S. Karger AG, Basel



Related Articles:

References

  1. Hammerer-Lercher A, Puschendorf B, Mair J: Cardiac natriuretic peptides: new laboratory parameters in heart failure patients. Clin Lab 2001;47:265–277.
    External Resources
  2. Clerico A, Iervasi G, Mariani G: Pathophysiologic relevance of measuring the plasma levels of cardiac natriuretic peptide hormones in humans. Horm Metab Res 1999;31:487–498.
    External Resources
  3. Clerico A, Del Ry S, Giannessi D: Measurement of cardiac natriuretic hormones (atrial natriuretic peptide, brain natriuretic peptide, and related peptides) in clinical practice: the need for a new generation of immunoassay methods. Clin Chem 2000;46:1529–1534.
    External Resources
  4. Clerico A, Emdin M: Diagnostic accuracy and prognostic relevance of the measurement of cardiac natriuretic peptides: a review. Clin Chem 2004;50:33–50.
    External Resources
  5. Vickery S, Price CP, John RI, Abbas NA, Webb MC, Kempson ME, Lamb EJ: B-type natriuretic peptide (BNP) and amino-terminal proBNP in patients with CKD: relationship to renal function and left ventricular hypertrophy. Am J Kidney Dis 2005;46:610–620.
    External Resources
  6. McCullough PA, Omland T, Maisel AS: B-type natriuretic peptides: a diagnostic breakthrough for clinicians. Rev Cardiovasc Med 2003;4:72–80.
    External Resources
  7. Jortani SA, Prabhu SD, Valdes RJ: Strategies for developing biomarkers of heart failure. Clin Chem 2004;50:265–278.
    External Resources
  8. Hobbs FDR, Davis RC, Roalfe AK, Hare R, Davies MK: Reliability of N-terminal proBNP assay in diagnosis of left ventricular systolic dysfunction within representative and high risk populations. Heart 2004;90:866–870.
    External Resources
  9. Lee SW, Song JH, Kim GA, Lim HJ, Kim M: Plasma brain natriuretic peptide concentration on assessment of hydration status in hemodialysis patient. Am J Kidney Dis 2003;41:1257–1266.
    External Resources
  10. McCullough PA, Duc P, Omland T, McCord J, Nowak RM, Hollander JE, Herrmann HC, Steg PG, Westheim A, Knudsen CW, Storrow AB, Abraham WT, Lamba S, Wu AHB, Perez A, Clop: B-type natriuretic peptide and renal function in the diagnosis of heart failure: an analysis from the Breathing Not Properly Multinational Study. Am J Kidney Dis 2003;41:571–579.
    External Resources
  11. Buckley MG, Sethi D, Markandu ND, Sagnella GA, Singer DR, MacGregor GA: Plasma concentrations and comparisons of brain natriuretic peptide and atrial natriuretic peptide in normal subjects, cardiac transplant recipients and patients with dialysis-independent or dialysis-dependent chronic renal failure. Clin Sci (Lond) 1992;83:437–444.
    External Resources
  12. Kohse KP, Feifel K, Mayer-Wehrstein R: Differential regulation of brain and atrial natriuretic peptides in hemodialysis patients. Clin Nephrol 1993;40:83–90.
    External Resources
  13. Akiba T, Tachibana K, Togashi K, Hiroe M, Marumo F: Plasma human brain natriuretic peptide in chronic renal failure. Clin Nephrol 1995;44 (suppl 1):S61–S64.
  14. Haug C, Metzele A, Steffgen J, Grunert A: Changes in brain natriuretic peptide and atrial natriuretic peptide plasma concentrations during hemodialysis in patients with chronic renal failure. Horm Metab Res 1994;26:246–249.
    External Resources
  15. Ishizaka Y, Yamamoto Y, Fukunaga T, Yokota N, Kida O, Kitamura K, Kangawa K, Minamino N, Matsuo H, Eto T: Plasma concentration of human brain natriuretic peptide in patients on hemodialysis. Am J Kidney Dis 1994;24:461–472.
    External Resources
  16. Leowattana W, Ong-Ajyooth L, Taruangsri P, Pokum S: Circulating N-terminal pro-brain natriuretic peptide and cardiac troponin T in chronic dialysis patients. J Med Assoc Thai 2003;86(suppl 1):S52–S58.
  17. Ishikura F, Ando Y, Park YD, Tani A, Shirai D, Matsuoka H, Miyatake K: Changes of plasma atrial and brain natriuretic peptide levels during hemodialysis. Ren Fail 1996;18:261–270.
    External Resources
  18. Nitta K, Kawashima A, Yumura W, Naruse M, Oba T, Kabaya T, Nihei H: Plasma concentration of brain natriuretic peptide as an indicator of cardiac ventricular function in patients on hemodialysis. Am J Nephrol 1998;18:411–415.
    External Resources
  19. Clerico A, Caprioli R, Del Ry S, Giannessi D: Clinical relevance of cardiac natriuretic peptides measured by means of competitive and non-competitive immunoassay methods in patients with renal failure on chronic hemodialysis. J Endocrinol Invest 2001;24:24–30.
    External Resources
  20. Osajima A, Okazaki M, Kato H, Anai H, Tsuda Y, Segawa K, Tanaka H, Tamura M, Takasugi M, Nakashima Y: Clinical significance of natriuretic peptides and cyclic GMP in hemodialysis patients with coronary artery disease. Am J Nephrol 2001;21:112–119.
    External Resources
  21. Wahl HG, Graf S, Renz H, Fassbinder W: Elimination of the cardiac natriuretic peptides B-type natriuretic peptide (BNP) and N-terminal proBNP by hemodialysis. Clin Chem 2004;50:1071–1074.
    External Resources
  22. Naganuma T, Sugimura K, Wada S, Yasumoto R, Sugimura T, Masuda C, Uchida J, Nakatani T: The prognostic role of brain natriuretic peptides in hemodialysis patients. Am J Nephrol 2002;22:437–444.
    External Resources
  23. Nishimura M, Hashimoto T, Kobayashi H, Fukukda T, Okino K, Yamamoto N, Nakamura N, Yoshikawa T, Takahashi H, Ono T: Different remodelling against left ventricular overload between diabetic and non-diabetic haemodialysis patients. Clin Exp Pharmacol Physiol 2003;30:786–792.
    External Resources
  24. Raymond I, Groenning BA, Hildebrandt PR, Nilsson JC, Baumann M, Trawinski J, Pedersen F: The influence of age, sex and other variables on the plasma level of N-terminal pro brain natriuretic peptide in a large sample of the general population. Heart 2003;89:745–751.
    External Resources
  25. Mallamaci F, Zoccali C, Tripepi G, Benedetto FA, Parlongo S, Cataliotti A, Cutrupi S, Giacone G, Bellanuova I, Stancanelli B, Malatino LS: Diagnostic potential of cardiac natriuretic peptides in dialysis patients. Kidney Int 2001;59:1559–1566.
    External Resources
  26. Cataliotti A, Malatino LS, Jougasaki M, Zoccali C, Castellino P, Giacone G, Bellanuova I, Tripepi R, Seminara G, Parlongo S, Stancanelli B, Bonanno G, Fatuzzo P, Rapisarda F, Belluardo P, Signorelli SS, Heublein DM, Lainchbury JG, Leskinen HK, Bailey: circulating natriuretic peptide concentrations in patients with end-stage renal disease: role of brain natriuretic peptide as a biomarker for ventricular remodeling. Mayo Clin Proc 2001;76:1111–1119.
    External Resources
  27. Zoccali C, Mallamaci F, Benedetto FA, Tripepi G, Parlongo S, Cataliotti A, Cutrupi S, Giacone G, Bellanuova I, Cottini E, Malatino LS: Cardiac natriuretic peptides are related to left ventricular mass and function and predict mortality in dialysis patients. J Am Soc Nephrol 2001;12:1508–1515.
    External Resources
  28. Haug C, Metzele A, Steffgen J, Kochs M, Hombach V, Grunert A: Increased brain natriuretic peptide and atrial natriuretic peptide plasma concentrations in dialysis-dependent chronic renal failure and in patients with elevated left ventricular filling pressure. Clin Investig 1994;72:430–434.
    External Resources
  29. Uetake S, Takahashi M, Tamano K, Honda T, Kobayashi T, Horinaka S: Clinical significance of plasma atrial and brain natriuretic peptide levels during hemodialysis in hemodialysis patients with old myocardial infarction. J Cardiol 2001;38:61–71.
    External Resources
  30. Nishikimi T, Futoo Y, Tamano K, Takahashi M, Suzuki T, Minami J, Honda T, Uetake S, Asakawa H, Kobayashi N, Horinaka S, Ishimitsu T, Matsuoka H: Plasma brain natriuretic peptide levels in chronic hemodialysis patients: influence of coronary artery disease. Am J Kidney Dis 2001;37:1201–1208.
    External Resources
  31. Iwashima Y, Horio T, Takami Y, Inenaga T, Nishikimi T, Takishita S, Kawano Y: Effects of the creation of arteriovenous fistula for hemodialysis on cardiac function and natriuretic peptide levels in CRF. Am J Kidney Dis 2002;40:974–982.
    External Resources
  32. Nakatani T, Naganuma T, Masuda C, Uchida J, Sugimura T, Sugimura K: Significance of brain natriuretic peptides in patients on continuous ambulatory peritoneal dialysis. Int J Mol Med 2002;10:457–461.
    External Resources
  33. Fagugli RM, Palumbo B, Ricciardi D, Pasini P, Santirosi P, Vecchi L, Pasticci F, Palumbo R: Association between brain natriuretic peptide and extracellular water in hemodialysis patients. Nephron Clin Pract 2003;95:c60–c66.
    External Resources
  34. Takahashi M, Nagake Y, Ichikawa H, Kawabata K, Nakazono H, Hirata K, Ogura T, Makino H: Plasma concentrations of natriuretic peptides in patients on hemodialysis. Res Commun Mol Pathol Pharmacol 1996;92:19–30.
    External Resources
  35. Corboy JC, Walker RJ, Simmonds MB, Wilkins GT, Richards AM, Espiner EA: Plasma natriuretic peptides and cardiac volume during acute changes in intravascular volume in haemodialysis patients. Clin Sci (Lond) 1994;87:679–684.
    External Resources
  36. Goto T, Takase H, Toriyama T, Sugiura T, Kurita Y, Tsuru N, Masuda H, Hayashi K, Ueda R, Dohi Y: Increased circulating levels of natriuretic peptides predict future cardiac event in patients with chronic hemodialysis. Nephron 2002;92:610–615.
    External Resources
  37. Ishii J, Cui W, Kitagawa F, Kuno T, Nakamura Y, Naruse H, Mori Y, Ishikawa T, Nagamura Y, Kondo T, Oshima H, Nomura M, Ezaki K, Hishida H: Prognostic value of combination of cardiac troponin T and B-type natriuretic peptide after initiation of treatment in patients with chronic heart failure. Clin Chem 2003;49:2020–2026.
    External Resources

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: November 26, 2004
Accepted: December 30, 2005
Published online: May 26, 2006
Issue release date: July 2006

Number of Print Pages: 1
Number of Figures: 6
Number of Tables: 5


eISSN: 1660-2110 (Online)

For additional information: https://www.karger.com/NEC

Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

Article Tools
Article Details

2006, Vol.103, No. 4

July 2006

Article

Recommend This
TOP