Abstract: PO0874
NT-ProBNP for Heart Function and Volume Status in Hemodialysis Patients
Session Information
- Fluid, Electrolytes, and Clinical Events with Dialysis: Getting to the "Heart" of the Matter
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
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
| Variables | NT-proBNP | P value | NT-proBNP | P value | |||
| <4058 (n=24) | ≥4058 (n=72) | <11576 (n=48) | ≥11576 (n=48) | ||||
| EF (%) | <55 | 1 (4.2) | 12 (16.7) | 0.174 | 3 (6.3) | 10 (20.8) | 0.070 |
| ≥55 | 23 (95.8) | 60 (83.3) | 45 (93.7) | 38 (79.2) | |||
| Diastolic dysfunction | Yes | 7 (29.2) | 53 (74.7) | <0.001 | 20 (41.7) | 40 (85.1) | <0.001 |
| No | 17 (70.8) | 18 (25.4) | 28 (58.3) | 7 (14.9) | |||
| LVH | Yes | 4 (16.7) | 37 (51.4) | 0.004 | 7 (14.6) | 34 (70.8) | <0.001 |
| No | 20 (83.3) | 35 (48.6) | 41 (85.4) | 14 (29.2) | |||