Division of Nephrology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, 170 Jomaru-ro, Bucheon 14584, Korea.
Division of Cardiology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, 170 Jomaru-ro, Bucheon 14584, Korea.
Medicina (Kaunas). 2022 Jul 22;58(8):975. doi: 10.3390/medicina58080975.
: N-terminal pro-brain natriuretic peptide (NT-proBNP) is a biomarker used to predict heart failure and evaluate volume status in hemodialysis (HD) patients. However, it is difficult to determine the cutoff value for NT-proBNP in HD patients. In this study, we analyzed whether NT-proBNP helps predict heart function and volume status in HD patients. : This prospective observational study enrolled 96 end-stage kidney disease patients with HD. All patients underwent echocardiography and bioimpedance spectroscopy (BIS) after an HD session. Overhydration (OH) was measured by BIS. Laboratory data were obtained preHD, while serum NT-proBNP was measured after HD. Interventions for blood pressure control and dry weight control were performed, and NT-proBNP was re-assessed after a month. : There was an inverse correlation between NT-proBNP and ejection fraction (EF) (β = -0.34, = 0.001). OH (β = 0.331, = 0.001) and diastolic dysfunction (β = 0.226, = 0.027) were associated with elevated NT-proBNP. In a subgroup analysis of diastolic dysfunction grade, NT-proBNP increased according to dysfunction grade (normal, 4177 pg/mL [2637-10,391]; grade 1, 9736 pg/mL [5471-21,110]; and grades 2-3, 26,237 pg/mL [16,975-49,465]). NT-proBNP showed a tendency toward a decrease in the 'reduced dry weight' group and toward an increase in the 'increased dry weight' group compared to the control group (ΔNT-proBNP, -210 pg/mL [-12,899 to 3142], = 0.104; 1575 pg/mL [-113 to 6439], = 0.118). : We confirmed that NT-proBNP is associated with volume status as well as heart function in HD patients.
N 端脑利钠肽前体（NT-proBNP）是一种用于预测心力衰竭和评估血液透析（HD）患者容量状态的生物标志物。然而，确定 HD 患者 NT-proBNP 的截断值很困难。在这项研究中，我们分析了 NT-proBNP 是否有助于预测 HD 患者的心功能和容量状态。
这项前瞻性观察研究纳入了 96 例接受 HD 的终末期肾病患者。所有患者在 HD 治疗后均行超声心动图和生物电阻抗光谱（BIS）检查。BIS 测量患者的超容量（OH）。在 HD 前获取实验室数据，在 HD 后测量血清 NT-proBNP。对血压控制和干体重控制进行干预，并在一个月后重新评估 NT-proBNP。
NT-proBNP 与射血分数（EF）呈负相关（β=-0.34， =0.001）。OH（β=0.331， =0.001）和舒张功能障碍（β=0.226， =0.027）与 NT-proBNP 升高相关。在舒张功能障碍分级的亚组分析中，随着功能障碍程度的增加，NT-proBNP 也随之增加（正常，4177pg/mL[2637-10391]；1 级，9736pg/mL[5471-21011]；2-3 级，26237pg/mL[16975-49465]）。与对照组相比，“减轻干体重”组 NT-proBNP 呈下降趋势，“增加干体重”组 NT-proBNP 呈上升趋势（ΔNT-proBNP，-210pg/mL[-12899-8942]， =0.104；1575pg/mL[-113-6439]， =0.118）。
我们证实 NT-proBNP 与 HD 患者的容量状态以及心功能相关。
