Value of B‐type natriuretic peptide in diagnosing left ventricular dysfunction in dialysis‐dependent patients

Abstract

B-type natriuretic peptide (BNP) is elevated in patients with end-stage renal failure. The reported accuracy of BNP in diagnosing left ventricular dysfunction in these patients has been inconsistent. To investigate the diagnostic values of BNP for left ventricular dysfunction in patients undergoing haemodialysis for chronic renal failure. We measured plasma BNP before and at 10 min and 3, 6 and 24 h after haemodialysis in 56 patients. The average plasma BNP before haemodialysis was 284 +/- 369 pg/mL, which was higher than that of healthy subjects (37 +/- 37 pg/mL; n = 32, P < 0.01). The average plasma BNP in patients with left ventricular dysfunction (n = 21) was substantially higher than that in those with normal ventricular function before and at 10 min and 3, 6 and 24 h after haemodialysis (P < 0.001). The area under the receiver operating characteristic curves was greater than 0.895 before and at the four time points after haemodialysis (P < 0.01). Using 152 pg/mL as a cut-off value, predialysis BNP has 81% sensitivity and 83% specificity in diagnosing left ventricular dysfunction in these patients. We concluded that plasma BNP offers a good sensitivity and specificity in diagnosing left ventricular dysfunction in patients with dialysis-dependent renal failure.