Modern peptide biomarkers and echocardiography in cardiac healthy haemodialysis patients

BMC Nephrology

Research Article

Volker Busch¹  Filip Barinka¹  Stephan Schiekofer¹  Wilma Gertrud Rasche²  Andreas Hagendorff³  Stephan Stoebe³  Thomas Ebert⁴  Silvana Feige⁴  Franz Maximilian Rasche⁴  Ulrich Sack⁵  Jochen G. Schneider⁶ 

[1] Center for Geriatric Medicine at Bezirksklinikum Regensburg, Universitätsstr. 84, 93053, Regensburg, Germany;Department of Head Medicine and Oral Health, Department of Ophthalmology, University Leipzig, Leipzig, Germany;Department of Internal Medicine, Neurology, Dermatology, Clinic for Cardiology and Angiology, University Leipzig, Leipzig, Germany;Department of Internal Medicine, Neurology, Dermatology, Clinic for Endocrinology, Diabetology and Nephrology, Section of Nephrology, University Leipzig, Leipzig, Germany;Institute of Clinical Immunology, Medical Faculty, University of Leipzig, Leipzig, Germany;Translational & Experimental Medicine, Luxembourg Centre de Systems Biomedicine, Luxembourg City, Luxembourg;Department of Internal Medicine II, Saarland University, Homburg Saar, Germany;

关键词: Haemodialysis;    Copeptin;    AVP;    MR-proANP;    NT-proBNP;    Cardiorenal syndrome;    Left ventricular dysfunction;   

DOI  :  10.1186/s12882-017-0589-3

 received in 2017-01-05, accepted in 2017-05-16,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundIn this prospective study, we aimed to assess the haemodynamic changes before and after haemodialysis (HD) in cardiac healthy subjects on chronic HD by imaging methods and endocrine markers of fluid balance.MethodsMid-regional pro-atrial natriuretic peptide (MR-proANP), N-terminal prohormone of brain natriuretic peptide (NT-proBNP), vasopressin (AVP) and copeptin (CT-proAVP), metanephrines and normetanephrines, renin and aldosterone, standard transthoracic echocardiography and diameter of vena cava inferior (VCID) were performed in 20 patients with end stage renal disease (CKD5D) before and after HD and were stratified in residual excretion (RE, less or more 0.5 l) and ultrafiltration rate (UF, less or more 2 l).ResultsCopeptin was significantly higher in patients before HD. Copeptin was inversely correlated with haemodialysis treatment adequacy (KT/v), RE and UF, but was not significantly influenced by age, gender and body mass index (BMI). MR-proANP was significantly reduced by haemodialysis by 27% and was inversely correlated with KT/v, but there was a significant influence by UF, RE, age, gender and BMI. NT-proBNP was significantly higher in patients before HD and was not influenced by RE and UF. Renin, aldosterone, metanephrines and normetanephrines did not demonstrate significant differences. Echocardiographic parameters and VCID were significantly correlated with RE, UF and copeptin.ConclusionModern biomarkers will provide cardiovascular risk assessment, but elimination (UF), RE and other factors may influence the serum concentrations, e.g. in patients with renal impairment. The interpretation will be limited by altered reference ranges, and will be restricted to individual courses combined with clinical and echocardiographic data.

【 授权许可】

CC BY   
© The Author(s). 2017