BNP and echocardiographic parameters in patients with chronic kidney disease and dialyzed patients
Authors:
I. Valočiková 1; G. Valočik 2; B. Krištofová 1; Ľ. Družbacká 2; R. Roland 3; P. Mitro 2
Authors‘ workplace:
I. interná klinika Lekárskej fakulty UPJŠ a FN L. Pasteura Košice, Slovenská republika, prednostka prof. MU Dr. Ivica Lazúrová, CSc.
1; III. interná klinika Lekárskej fakulty UPJŠ a FN L. Pasteura Košice, Slovenská republika, prednosta doc. MU Dr. Peter Mitro, Ph. D.
2; FRESENIUS, Nefrologické a dialyzačné centrum Košice, Slovenská republika, prednosta prim. MU Dr. Robert Roland
3
Published in:
Vnitř Lék 2009; 55(10): 934-939
Category:
Original Contributions
Overview
We assessed the relation between BNP levels and some echocardiographic parameters of systolic and diastolic function of the left ventricle in 49 patients (mean age 69.39 ± 8.47 years) with chronic kidney disease in different stages of chronic renal failure according to K/ DOQI and in 45 subjects (mean age 52.6 ± 14.85 years) on dialysis. Median for BNP in the group of patients with chronic renal failure was 132 pg/ ml, and in dialysis subjects 320 pg/ ml. None of our patients had clinical signs of heart failure during the last six months. Using a method of correlation matrix we found the left ventricular mass and its indexed value as a common indicator of increased BNP level in both groups of patients (dialysis patients, p = 0.0003, and p = 0.0005, respectively; patients with chronic renal failure, p = 0.03, and p = 0.04, respectively). Further analysis proved that in the group of dialysis patients the main determinants of increased BNP level were volumes of the left heart side: left ventricular enddiastolic volume (p = 0.004), endsystolic volume (p = 0.01), and left atrial volumes (maximal, minimal, and total atrial stroke volume; p = 0.004, p = 0.009 a p = 0.04, respectively). In the group of patients with chronic renal failure the major contributors to increased BNP level were echocardiographic parameters of diastolic filling assessed from transmitral and pulmonary venous flow: E wave (p = 0.001), A wave (p = 0.01), E/ A (p
Key words:
chronic renal disease – chronic renal failure – systolic and diastolic dysfunction – cardiac biomarkers – BNP
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