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ProBNP in hemodialysis patients

Yuji Sato, Toshihide Hayashi, Nobuhiko Joki, Shouichi Fujimoto
In dialysis patients, electrocardiogram (ECG) abnormalities are common. However, the associations between the T-wave of the lead aVR (aVRT) amplitude and cardiovascular (CV) events or total mortality are unknown. We performed a prospective, observational cohort study of prevalent hemodialysis patients (N = 474), followed for 4 years. Outcomes were composite CV events and all-cause mortality. Predictors were baseline aVRT and other ECG findings. ECG parameters were analyzed in three models: model 1, univariate; model 2, basic adjustments; and model 3, model 2 plus serum albumin, C-reactive protein level, and NT-proBNP...
March 10, 2017: Therapeutic Apheresis and Dialysis
Bryan A Ross, Ron Wald, Marc B Goldstein, Darren A Yuen, Jonathon Leipsic, Mercedeh Kiaii, Andrea Rathe, Djeven P Deva, Anish Kirpalani, Olugbenga O Bello, John J Graham, Howard Leong-Poi, Kim A Connelly, Andrew T Yan
BACKGROUND: We sought to assess the relationships between left ventricular (LV) remodelling and the mechanical and uremic stressors in hemodialysis patients. METHODS: In this prospective 2-centre cohort study, 67 prevalent hemodialysis patients were followed for 1 year. Data on routine bloodwork and predialysis blood pressure (BP) measurements were collected over a 12-week period. LV end-diastolic volume (LVEDV) and LV mass (LVM) were measured using cardiac magnetic resonance imaging and indexed...
April 2017: Canadian Journal of Cardiology
Lan Chen, Ying-Ying Chen, Yi-Sheng Ling, Chun-Hua Lin, Jin-Xuan He, Tian-Jun Guan
BACKGROUND: Serum N-terminal probrain natriuretic peptide (NT-proBNP) level is known to be strongly associated with fluid overload, and serves as a guide for fluid management in patients on hemodialysis (HD). This study aimed at investigating the relationship between NT-proBNP level and blood pressure (BP), ultrafiltration/dry weight ratio as well as hemoglobin, and to explore the optimal cutoff point of NT-proBNP level in Chinese patients on HD. METHODS: A total of 2306 patients on maintained HD for stage 5 chronic kidney disease (CKD) were included in this prospective study...
November 2017: Renal Failure
Zhen Zhang, Bo Shen, Xuesen Cao, Zhonghua Liu, Xiaohong Chen, Yuxin Nie, Jinbo Yu, Jianzhou Zou, Xiaoqiang Ding
BACKGROUND: Soluble suppression of tumorigenicity 2 (sST2) is a novel cardiovascular biomarker. This study aimed to evaluate the prognostic value of sST2 in hemodialysis patients. METHODS: Four hundred and fourteen maintenance hemodialysis (MHD) patients were enrolled and followed up prospectively. Serum sST2 levels were measured. The endpoint was all-cause and cardiovascular mortality. RESULTS: During a median follow-up of 22.3 months, 58 patients died, including 31 cardiovascular deaths...
2017: Blood Purification
Misa Ikeda, Hirokazu Honda, Keiko Takahashi, Kanji Shishido, Takanori Shibata
Protein-energy wasting (PEW) is common in hemodialysis (HD) patients. A recent study demonstrated that a high level of N-terminal pro-B-type natriuretic peptide (NT-proBNP) may be associated with PEW in those patients. This prospective study aimed to assess the association of NT-proBNP with body composition and muscle loss. A cohort of prevalent HD patients (n = 238) was examined. Blood samples were obtained at baseline to measure high-sensitive C-reactive protein (hsCRP), interleukin-6 (IL-6), adiponectin and NT-proBNP...
2016: PloS One
Yujiro Okute, Tetsuo Shoji, Tomoshige Hayashi, Yukinobu Kuwamura, Mika Sonoda, Katsuhito Mori, Atsushi Shioi, Yoshihiro Tsujimoto, Tsutomu Tabata, Masanori Emoto, Masaaki Inaba
AIM: The cardiothoracic ratio (CTR) on a chest X-ray is an indicator of cardiac enlargement, although its predictive power for cardiovascular disease (CVD) events in chronic kidney disease is unknown. We examined it in a cohort of hemodialysis patients, as compared with an N-terminal fragment of probrain natriuretic peptide (NT-proBNP). METHOD: This was an observational study with cross-sectional and longitudinal analyses including 517 maintenance hemodialysis patients and 122 healthy control subjects...
September 13, 2016: Journal of Atherosclerosis and Thrombosis
Masaru Obokata, Hiroaki Sunaga, Hideki Ishida, Kyoko Ito, Tetsuya Ogawa, Yoshitaka Ando, Masahiko Kurabayashi, Kazuaki Negishi
UNLABELLED: End-stage renal disease is a major clinical and public health problem, and cardiovascular disease accounts for half of the mortality in hemodialysis patients. An existing mortality risk score (AROii score) or N-terminal pro-brain natriuretic peptide (NT-proBNP) level have modest predictive power, but there is room for improvement. There are emerging cardiac biomarkers (soluble isoforms of ST2 [sST2], galectin-3 [Gal-3]), and uremic toxicity (indoxyl sulfate). We sought to determine whether these biomarkers predict cardiovascular outcomes in hemodialysis patients and have incremental prognostic value over the clinical score and NT-proBNP level...
September 2016: American Heart Journal
T E Rudenko, M P Vasil'eva, N I Solomakhina, I M Kutyrina
AIM: To investigate the incidence and risk factors of pulmonary hypertension (PH) in patients with chronic kidney disease (CKD). SUBJECTS AND METHODS: 86 patients (53% men, 47% women; mean age, 45±13 years) with nondiabetic CKD were examined. According to the magnitude of glomerular filtration rate (GFR) decrease, all the patients were divided into 3 groups: 1) 33 patients with a GFR of 89--45 ml/min; 2) 33 with a GFR of 44--15 ml/min; 3) 20 with a GFR of <15 ml/min who were treated with hemodialysis...
2016: Terapevticheskiĭ Arkhiv
Reneta Yovcheva Koycheva, Vasil Cholakov, Jivko Andreev, Margarit Penev, Rosen Iliev, Krasimira Nancheva, Vanya Tsoneva
BACKGROUND: Cardiac biomarkers are often elevated in dialysis patients showing the presence of left ventricular dysfunction. The aim of the study is to establish the plasma levels of high-sensitivity cardiac troponin T (hs TnT), precursor of B-natriuretic peptide (NT-proBNP) and high sensitivity C-reactive protein (hs CRP) and their relation to the presence of left ventricular hypertrophy (LVH) in patients undergoing hemodialysis without signs of acute coronary syndrome or heart failure...
March 15, 2016: Open Access Macedonian Journal of Medical Sciences
Francesca Viazzi, Giovanna Leoncini, Elena Ratto, Giulia Storace, Annalisa Gonnella, Debora Garneri, Barbara Bonino, Francesca Cappadona, Emanuele L Parodi, Daniela Verzola, Giacomo Garibotto, Roberto Pontremoli
BACKGROUND: Patients undergoing chronic hemodialysis (HD) are at increased risk for peripheral artery disease (PAD). Both ankle-brachial index (ABI) and ambulatory blood pressure monitoring (ABPM) in the interdialytic period have been shown to be strong predictors of all-cause mortality. METHODS: This cross-sectional study investigated the relationship between ABPM profile and ABI in 81 HD patients. ABPM was measured throughout a 44-h midweek interdialytic period...
June 1, 2016: Journal of Nephrology
Margarita S Biragova, Svetlana A Gracheva, Alexandra M Glazunova, Sergey A Martynov, Irina N Ulaynova, Alexandr V Ilyin, Yury I Philippov, Guliya M Musaeva, Minara S Shamkhalova, Marina V Shestakova
AIMS: The objective of our study was to evaluate the role of mineral and bone metabolism disorders associated with chronic kidney disease (MBD-CKD) in the development and progression of cardiac and renal pathology in patients with type 1 diabetes mellitus (T1DM) of long duration. METHODS: We investigated 96 patients with T1DM of long duration, with CKD at different stages (0-5), including patients on hemodialysis (HD) and with kidney transplantation (KT). Along with overall clinical examination, we assessed markers of MBD (calcium, phosphorus, parathormone, vitamin D, fibroblast growth factor (FGF) 23) and levels of cardiac injury marker (atrial natriuretic peptide, NT-proBNP)...
August 2016: Diabetes Research and Clinical Practice
Fredrik Uhlin, Ingegerd Odar-Cederlöf, Elvar Theodorsson, Anders Fernström
BACKGROUND/AIMS: Plasma concentrations of the N-terminal fragment of pro-brain natriuretic peptide (NT-proBNP) are increased in end-stage renal disease. Improvement in hemodynamic stability has been reported when switching from hemodialysis (HD) to on-line hemodiafiltration (ol-HDF). The aim of this study was to investigate plasma concentrations of NT-proBNP, BNP and neuropeptide Y (NPY) during a 1-year follow-up, after a change from high-flux HD to postdilution ol-HDF. Additional variables were also studied, e...
September 2015: Nephron Extra
Terumi Higuchi, Masanori Abe, Toshio Yamazaki, Erina Okawa, Hideyuki Ando, Sunao Hotta, Osamu Oikawa, Fumito Kikuchi, Kazuyoshi Okada, Masayoshi Soma
BACKGROUND: Levocarnitine deficiency in hemodialysis patients is common. Although the effect of levocarnitine therapy on uremic anemia has been studied in small trials, its effects on cardiac function remain unclear. STUDY DESIGN: Multicenter, prospective, open-label, parallel, randomized, controlled trial. SETTING & PARTICIPANTS: Patients undergoing maintenance hemodialysis with carnitine deficiency (free carnitine plasma concentration < 40μmol/L) enrolled in 3 hemodialysis centers...
February 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Thomas Mueller, Alfons Gegenhuber, Gert Kronabethleitner, Isabella Leitner, Meinhard Haltmayer, Benjamin Dieplinger
OBJECTIVES: Biomarkers are useful for establishing disease severity or prognosis in patients with chronic kidney disease. The aim of our study was to determine the plasma concentrations of novel cardiovascular biomarkers in patients on chronic hemodialysis in the context of published upper reference limits (URL) of these biomarkers; and to compare the plasma concentrations of those same analytes before and after hemodialysis session. DESIGN AND METHODS: Plasma concentrations of N-terminal pro-B-type natriuretic peptide (NT-proBNP), mid-regional pro-A-type natriuretic peptide (MR-proANP), mid-regional pro-adrenomedullin (MR-proADM), C-terminal pro-endothelin-1 (CT-proET-1), C-terminal pro-arginine vasopressin (CT-proAVP, also known as Copeptin) and soluble ST2 (sST2) were measured in 28 patients before and after dialysis session...
November 2015: Clinical Biochemistry
Krzysztof Schwermer, Krzysztof Hoppe, Dorota Radziszewska, Patrycja Kłysz, Peter Sawatiuk, Justin Nealis, Małgorzata Kałużna, Jolanta Kaczmarek, Ewa Baum, Bengt Lindholm, Krzysztof Pawlaczyk, Andrzej Oko
INTRODUCTION: N‑terminal pro‑B‑type natriuretic peptide (NT‑proBNP) is an established biomarker of heart failure in the general population. However, its diagnostic value is unclear in hemodialysis (HD) patients owing to renal insufficiency. OBJECTIVES: The aim of the study was to establish the usefulness of NT‑proBNP for hydration assessment and the relation of NT‑proBNP to the nutritional state and prognosis of survival. PATIENTS AND METHODS: In 321 HD patients (206 men; mean age, 65...
2015: Polskie Archiwum Medycyny Wewnętrznej
Christopher E Williams, Bryan M Curtis, Edward W Randell, Robert N Foley, Patrick S Parfrey
BACKGROUND: Health Related Quality of Life (HRQOL) is impaired in hemodialysis patients and cardiac biomarkers are elevated, but their relationship is uncertain. OBJECTIVES: To determine whether the cardiac biomarkers, troponin T and N terminal pro-B type natriuretic peptide (NT-proBNP), predict deterioration in the physical domains of HRQOL. DESIGN: A prospective cohort study of patients in a randomized controlled clinical trial of correction of anemia with erythropoietin...
2014: Canadian Journal of Kidney Health and Disease
Esmée M Ettema, Johanna Kuipers, Solmaz Assa, Stephan J L Bakker, Henk Groen, Ralf Westerhuis, Carlo A J M Gaillard, Ron T Gansevoort, Casper F M Franssen
OBJECTIVES: Plasma levels of copeptin, a surrogate marker for the vasoconstrictor hormone arginine vasopressin (AVP), are increased in hemodialysis patients. Presently, it is unknown what drives copeptin levels in hemodialysis patients. We investigated whether the established physiological stimuli for copeptin release, i.e. plasma osmolality, blood volume and mean arterial pressure (MAP), are operational in hemodialysis patients. METHODS: One hundred and eight prevalent, stable hemodialysis patients on a thrice-weekly dialysis schedule were studied during hemodialysis with constant ultrafiltration rate and dialysate conductivity in this observational study...
2015: PloS One
Emilie Laveborn, Krister Lindmark, Malin Skagerlind, Bernd Stegmayr
BACKGROUND: Brain natriuretic peptide (BNP), N-terminal-proBNP (NT-proBNP), and high sensitive cardiac troponin T (TnT) are markers that are elevated in chronic kidney disease and correlate with increased risk of mortality. Data are conflicting on the effect of biomarker levels by hemodialysis (HD).Our aim was to clarify to what extent HD with low-flux (LF) versus high-flux (HF) membranes affects the plasma levels of BNP, NT-proBNP, and TnT. METHODS AND MATERIALS: 31 HD patients were included in a crossover design, randomized to start dialysis with a LF-HD or HF-HD dialyzer...
February 2015: International Journal of Artificial Organs
Mileta Poskurica, Dejan Petrović
Cardiovascular disorders are the most frequent cause of death (46-60%) among patients with advanced chronic renal failure (CRF), and on dialysis treatment. Uremic cardiomyopathy is the basic pathophysiologic substrate, whereas ischemic heart disease (IHD) and anemia are the most important contributing factors. Associated with well-know risk factors and specific disorders for terminal kidney failure and dialysis, the aforementioned factors instigate congestive heart failure (CHF). Suspected CHF is based on the anamnesis, clinical examination and ECG, while it is confirmed and defined more precisely on the basis of echocardiography and radiology examination...
November 2014: Srpski Arhiv za Celokupno Lekarstvo
Magid A Fahim, Andrew Hayen, Andrea R Horvath, Goce Dimeski, Amanda Coburn, David W Johnson, Carmel M Hawley, Scott B Campbell, Jonathan C Craig
BACKGROUND AND OBJECTIVES: Monitoring N-terminal pro-B-type natriuretic peptide (NT-proBNP) may be useful for assessing cardiovascular risk in dialysis patients. However, its biologic variation is unknown, hindering the accurate interpretation of serial concentrations. The aims of this prospective cohort study were to estimate the within- and between-person coefficients of variation of NT-proBNP in stable dialysis patients, and derive the critical difference between measurements needed to exclude biologic and analytic variation...
April 7, 2015: Clinical Journal of the American Society of Nephrology: CJASN
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