Is Plasma Concentration of NT-Pro-Brain Natriuretic Peptide Associated with Left Ventricle Hypertrophy among Hemodialysis Patients?

Abstract

OBJECTIVE To determine the association of plasma amino terminal pro-brain natriuretic peptide (NT-proBNP) level with left ventricle hypertrophy (LVH) among hemodialysis (HD) patients. METHODS We evaluated 65 patients on maintenance HD (28 women, 37 men) treated thrice weekly by low-flux hollow-fiber dialyzers for at least 6 months. Patients were divided into 2 groups according to whether they had LVH. NT-proBNP concentration of the patients was measured before and after the HD session. Cardiac parameters were detected by echocardiography after the day of HD after the session. RESULTS In group 1 were the 34 patients who were LVH(−) (19 women and 15 men) and in group 2 were the 31 patients who were LVH(+) (9 women and 22 men). Mean left ventricular posterior wall diameter (LVPWd) was 0.87 ± 0.16 cm in group 1 and 1.28 ± 0.16 cm in group 2 (p < .001). Men were predominant in group 2 (p = .029). The patients in group 2 were older than those in group 1 (p = .033). There were no significant differences between the groups in pre-HD and post-HD NT-proBNP levels (p = .163 and p = .327, respectively). We did not find any significant relationship between mean concentration of pre-HD NT-proBNP and LVPWd (r = 0.064, p = 0.612). A positive correlation was found between mean concentration of pre-HD NT-proBNP with age (r = 0.281, p = 0.023), MAP (r = 0.469, p < 0.001), and left atrial diameter (r = 0.322, p = 0.009). CONCLUSION Although increased serum levels of NT-proBNP in HD patients was found to be related to LAd, an indicator of hypervolemia, there was no association between NT-proBNP and LVH. Elevation of NT-proBNP is affected by multiple factors such as age, sex, arterial blood pressure, and dialyzer membrane.