ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: PO0874

NT-ProBNP for Heart Function and Volume Status in Hemodialysis Patients

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Lee, Kyung Ho, Soonchunhyang University Hospital Bucheon, Bucheon, Gyeonggi-do, Korea (the Republic of)
  • Oh, Young seung, Soonchunhyang University Hospital Bucheon, Bucheon, Gyeonggi-do, Korea (the Republic of)
  • Yu, Byung chul, Soonchunhyang University Hospital Bucheon, Bucheon, Gyeonggi-do, Korea (the Republic of)
  • Park, Moo Yong, Soonchunhyang University Hospital Bucheon, Bucheon, Gyeonggi-do, Korea (the Republic of)
  • Kim, Jin kuk, Soonchunhyang University Hospital Bucheon, Bucheon, Gyeonggi-do, Korea (the Republic of)
  • Hwang, Seung Duk, Soonchunhyang University Hospital Bucheon, Bucheon, Gyeonggi-do, Korea (the Republic of)
  • Choi, Soo Jeong, Soonchunhyang University Hospital Bucheon, Bucheon, Gyeonggi-do, Korea (the Republic of)
Background

N-terminal pro brain natriuretic peptide (NT-proBNP) is a biomarker that predicts heart failure and evaluates volume status in Hemodialysis (HD) patients. However, it is difficult to determine the cutoff value of NT-proBNP in HD patients. In this study, we analyzed whether NT-proBNP helps with predicting heart function and volume status in HD patients.

Methods

Retrospective study was conducted on 96 end-stage renal disease patients with HD. All patients underwent echocardiography and Bioelectrical Impedance Analysis (BIA) after a post HD session. Overhydration (OH) was measured by BIA. Laboratory data were obtained on preHD during the mid-week HD sessions. Serum NT-proBNP was measured after HD.

Results

There was an inverse correlation between NT-proBNP and ejection fraction (EF) (β= -0.34, P=0.001). Overhydration (OH) (β=0.33, p=0.001) and presence of diastolic dysfunction (β=0.226, P=0.027) had positive correlations with NT-proBNP. In the subgroup analysis with diastolic dysfunction grade, NT-proBNP increased as the dysfunction grade increased. (diastolic dysfunction grade 0; 4177(2637-10391), grade 1; 9736 (5471-21110), grade 2,3; 24627(16975-44988)) Elevation of NT-proBNP above 4058 pg/ml was associated with the presence of diastolic dysfunction (p<0.001) and Left ventricular hypertrophy (LVH) (p=0.004). Elevation of NT-proBNP above 11576 pg/ml was associated with the presence of diastolic dysfunction (P<0.001), LVH (p<0.001) as well as EF<55% (P=0.07). The group with lowered dry weight followed up NT-proBNP one month later, compared to the group with no change in dry weight, NT-proBNP showed a tendency to decrease, and the group with no change in dry weight showed a relatively low level of NT-proBNP variability. (-210 (-12899 - 3142) vs 330(-1090 - 3858); interquartile range, p=0.104)

Conclusion

We confirmed that NT-proBNP is associated with volume status as well as heart functions such as diastolic dysfunction, LVH and EF in HD patients.

Heart function according to NT-proBNP level
VariablesNT-proBNPP valueNT-proBNPP value
<4058
(n=24)
≥4058
(n=72)
<11576
(n=48)
≥11576
(n=48)
EF (%)<551 (4.2)12 (16.7)0.1743 (6.3)10 (20.8)0.070
≥5523 (95.8)60 (83.3)45 (93.7)38 (79.2)
Diastolic dysfunctionYes7 (29.2)53 (74.7)<0.00120 (41.7)40 (85.1)<0.001
No17 (70.8)18 (25.4)28 (58.3)7 (14.9)
LVHYes4 (16.7)37 (51.4)0.0047 (14.6)34 (70.8)<0.001
No20 (83.3)35 (48.6)41 (85.4)14 (29.2)