Clinical InvestigationCongestive Heart FailureThe use of B-type natriuretic peptide to assess volume status in patients with end-stage renal disease
Section snippets
Study population
The University of California, San Diego, Institutional Review Board and the Veterans Affairs research committee approved this study. The participants included 39 patients with ESRD undergoing HD 3 times a week for at least 30 days at the San Diego Veterans Healthcare System. Blood samples were collected at the start and end of each of 3 consecutive dialysis sessions on a Monday-Wednesday-Friday or a Tuesday-Thursday-Saturday schedule. Pre- and posttreatment weights and blood pressures were
Overview
Table I shows the characteristics of all 39 patients—aged 64 ± 2 years (mean ± SEM), male-female ratio of 37:2—undergoing HD 3 times a week for at least 30 days. Most patients (95%) had a history of hypertension, whereas 68% had diabetes, 35% had congestive heart failure (CHF), 38% had coronary artery disease, and 24% had peripheral vascular disease. Patients underwent a total of 117 dialysis procedures conducted on either a Monday-Wednesday-Friday or Tuesday-Thursday-Saturday schedule. The
Discussion
Plasma BNP and estimated glomerular filtration rate have been shown to be related to prognosis in CHF.18, 19 However, the relationships between estimated glomerular filtration rate, BNP, and CHF are not fully understood. The BNP is cleared by the natriuretic peptide receptor system found both on the vascular endothelium and in the renal parenchyma. It is also cleared by plasma neutral endopeptidases, which are ubiquitous.20, 21 This suggests that endogenous BNP is cleared by both renal and
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Water – A life-giving toxin – A nephrological oxymoron. Health consequences of water and sodium balance disorders. A review article
2022, Advances in Medical SciencesCitation Excerpt :Similar discrepancies exist with regard to utility of NPs in determination of fluid removal during dialysis. There are data neglecting their value [95,96] as well as suggesting improved care in this population [97]. All this conflicting data may be partially explained by large inter- and intra-patient variability of the peptides.
BNP and obesity in acute decompensated heart failure with preserved vs. reduced ejection fraction: The Atherosclerosis Risk in Communities Surveillance Study
2017, International Journal of CardiologyCitation Excerpt :Since only a small proportion of hospitalizations had NT-proBNP levels available (unweighted N = 359) and because NT-proBNP cannot be interpreted on the same scale as BNP, we only included hospitalizations with BNP levels recorded. In addition, we excluded hospitalizations of patients on dialysis, because BNP levels in patients with end stage renal disease are higher, vary with timing of dialysis and type of dialysis membrane used, and may not correlate with estimated volume overload [12–14]. We used measurements of weight, height, systolic blood pressure and heart rate at the time of admission.
The potential role of natriuretic peptide-guided management for patients hospitalized for heart failure
2015, Journal of Cardiac FailureDo Natriuretic Peptide Measurements Provide Insights into Management of End-Stage Renal Disease Patients Undergoing Dialysis?
2020, Current Heart Failure ReportsComparison between lung ultrasonography and current methods for volume assessment in Asian chronic hemodialysis patients
2020, Hemodialysis International
Dr Maisel receives research support from Bayer Diagnostics (Tarrytown, NY), who supplied assay kits for this study.