#2871 BRAIN NATRIURETIC PEPTIDE LEVEL IN CHRONIC EGYPTIAN HEMODIALYSIS PATIENTS: ITS RELATION TO VENTRICULAR FUNCTION AND VOLUME STATUS

Abstract

Abstract Background and Aims Volume overload is major problem in chronic hemodialysis patient and BNP level is related to volume status of the patient . Aims To assess BNP level in hemodialysis patient before and after HD session and to study its role as a marker for volume overload in hemodialysis patient depending on clinical findings and echocardiography parametershemodialysis. Method The study was conducted on 50 patients of Nephrology and hemodialysis unit, Mansoura University Hospital. Our patients were classified according to left ventricular mass index (LVMI) into patients with left ventricular hypertrophy (LVH)(35 patients) and patients without LVH (15 patients). We classified our patients into another two groups according to predialysis BNP level to group with BNP level˃100pg/ml(33 patients) which was associated with cardiac dysfunction and group with BNP level˂100pg/ml (17 patients). Results In the present study, the median of pre-dialysis BNP level was 126 pg/ml and the median of post- dialysis BNP was 25 pg/ml, this demonstrate that BNP plasma level decline after the hemodialysis session. Among The studied patients, the mean of predialysis systolic BP in patients with high BNP level ˃100 pg/ml is (155.65) higher than patients with low BNP level˂100 pg/ml . The incidence of lower limb edema, congested neck veins and chest crepitations was high in the group with BNP level (˃100 pg/ml) when compared with BNP level (<100 pg/ml). In the present study, according to ROC curve, predialysis BNP level may be a marker for lower limb edema with cutoff point (140.8) pg/ml with (85%) sensitivity and (77%) specificity and shows that the best cutoff point of predialysis BNP level in prediction of neck veins is (40.4) pg/ml with (94%) sensitivity and(28%) specificity and shows that the best cutoff point of predialysis BNP level in prediction of chest crepitation is (42.8) with (82%) sensitivity and (30%) specificity . Conclusion In Egyptian hempodialysis patients, there is a negative correlation between BNP predialysis and weight pre and post dialysis.There is significant correlation between BNP postdialysis and systoilc BP predialysis, RVD and COP. There is signifcant correlation between delta BNP and systoilc BP predialysis and ultrafiltration volume.