DIAGNOSTIC EFFİCACY OF NATRIURETIC PEPTIDE: NT-proBNP IN HEMODIALYSIS PATIENTS WITH LEFT VENTRICULAR FAILURE

Abstract

Objective: In the general population, plasma concentrations of natriuretic peptides such as brain natriuretic peptide (BNP), are useful markers to predict left ventricular hypertrophy and left ventricular (LV) systolic dysfunction. Left ventricular hypertrophy in dialysis patients is exceedingly frequent and predicts mortality in these patients. LV systolic dysfunction is also frequent due to high coronary artery disease (CAD) prevalence in this population. The present study aimed to evaluate the clinical diagnostic potential of N-terminal pro-brain natriuretic peptide (NT-proBNP); as an indicator for left ventricular (LV) systolic dysfunction and left ventricular mass (LVM), in chronic hemodialysis patients. Material and Method: 76 patients with end-stage renal disease (54 males and 22 females, mean age 60.51±13.96 years) who had been on regular hemodialysis treatment twice or three times a week were enrolled in this study. Patients were divided into two groups based on left ventricular ejection fraction (LVEF). Left ventricular systolic dysfunction was defined as LVEF ≤40%. Basic biochemical parameters, NT-proBNP, and echocardiographic parameters including left ventricular mass (LVM) and left ventricular mass index (LVMI) were measured. Results: Mean concentration of serum NT-proBNP was 8333 (208-35000) pg/ml, and this parameter was not significantly different between the two groups (13136 (361-35000) pg/ml vs. 6617 (20-33805) pg/ml, p:0.16). Multivariate analysis results of logarithmic transformed NT-proBNP showed correlation only with RVEF. The left ventricular end-systolic diameter was significantly lower in the normal LV systolic function group (35.4±8.2 vs. 31.3±7.1 mm, p:0.04). Conclusion: Our findings suggest that NT-proBNP is inadequate to determine LV systolic dysfunction in chronic hemodialysis patients.