N-terminal brain natriuretic peptide used for evaluation of dry weight in patients undergoing maintenance hemodialysis

Objective To observe N-terminal brain natriuretic peptide(NT-proBNP) used for evaluation of dry weight in maintenance hemodialysis(MHD) patients and analyze the clinical significance.Methods Forty-eight patients undergoing MHD were divided into dry weight group(n=24)and capacity overload group(n=24)...

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Main Authors: TANG Xiao-fang, YAN Lian-xi, LI Kang-feng, SHI Ping, YAN Ning, WANG Cheng-shuang, KONG Ru-xi, ZHOU Yu-kun
Format: Article
Language:zho
Published: Editorial Department of Journal of Clinical Nephrology 2016-01-01
Series:Linchuang shenzangbing zazhi
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Online Access:http://www.lcszb.com/thesisDetails?columnId=57918590&Fpath=home&index=0
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Summary:Objective To observe N-terminal brain natriuretic peptide(NT-proBNP) used for evaluation of dry weight in maintenance hemodialysis(MHD) patients and analyze the clinical significance.Methods Forty-eight patients undergoing MHD were divided into dry weight group(n=24)and capacity overload group(n=24).The age,mean arterial pressure(MAP),cardiothoracic ratio,left ventricular ejection fraction(LVEF),left ventricular volume(LV),N-terminal brain natriuretic peptide,serum creatinine,urea nitrogen,and estimated glomerular filtration rate(eGFR) were compared between the two groups before treatment NT-proBNP,serum creatinine and urea nitrogen were detected before and after routine dialysis in the two groups and the urea clearance index(Kt/V)was calculated,and NT-proBNP,serum creatinine and urea nitrogen were detected before the next dialysis.Results There were no significant differences in age,LVEF,LV and serum creatinine,urea nitrogen,eGFR before dialysis between two groups.MAP[(88.10±10.16)mm Hg vs.(93.92±8.03)mm Hg],cardiothoracic ratio[(48.80±6.11)%vs.(53.25±2.72)%]and NT-proBNP[(3827.67±712.12)ng/L vs.(5793.58±945.20)ng/L]in dry weight group were significantly reduced as compared with capacity overload group(P<0.05 or P<0.01).There were statistically significant differences in the changes of NT-proBNP[(1 847.77 ± 802.54) ng/L vs.(3 023.58 ±876.56) ng/L]and serum creatinine[(287.26 ± 62.86) μmol/L vs.(298.86 ± 74.57) μmol/L]between the two groups after dialysis(P<0.01).There was no statistically significant difference in the NT-proBNP and serum creatinine detected before the next dialysis from the previous dialysis(P>0.05).The median of NT-proBNP values in the two groups was significantly higher than the normal value range.Conclusions The NT-proBNP increased,indicating capacity overload was ubiquitous in MHD patients with no dominant edema.NT-proBNP could be used to evaluate the no dominant edema capacity load of MHD patients,but there were limitations.Physical examination and multiple detection comprehensive evaluation are used to determinate dry weight of MHD patients.
ISSN:1671-2390