Korean J Nephrol.  2007 Mar;26(2):212-219.

Brain Natriuretic Peptide (BNP), N-terminal pro-BNP (NT-proBNP) and Cardiac Troponin T (cTnT) as Markers of Cardiac Diseases in Stable Hemodialysis Patients

• Baek H
• Kim JA
• Choi SY
• Do YS
• Jang EH
• Kim JI
• Do JH
• Choi SC
• Lee JE
• Huh W
• Kim DJ
• Oh HY
• Park SW
• Ki CS
• Kim YG

Abstract

PURPOSE: The prevalence of coronary artery disease and left ventricular hypertrophy (LVH) is higher in patients with chronic kidney disease (CKD) than in the general population. In the general population, BNP, NT-proBNP, and cTnT are useful markers of cardiac disease. Recently, studies on biomarkers in patients with CKD have been reported. However, the effect of renal disease on these markers is still uncertain particularly in hemodialysis patients. We investigated the potential of BNP, NT-proBNP, and cTnT as biomarkers of cardiac disease in hemodialysis patients.
Methods
We prospectively studied 27 hemodialysis patients without cardiovascular event within the last 6 months. We performed an echocardiography and blood samples for plasma BNP, NT-proBNP and cTnT.
RESULTS
Median BNP, NT-proBNP, and cTnT level (pg/mL) were 433, 10,598, and 0.021, respectively. NT-proBNP was correlated with BNP (r=0.940, p=0.000) and cTnT (r=0.504, p=0.009). There was a negative correlation between BNP and left ventricular ejection fraction (LVEF) (r=-0.502, p=0.008), between NT-proBNP and LVEF (r=-0.556, p=0.003), and between cTnT and LVEF (r=-0.513, p=0.007). There was a positive correlation between BNP and LV mass index (LVMI) (g/m2) (r=0.619, p=0.001). Also, a positive correlation between NT-proBNP and LVMI was shown (r=0.718, p=0.000). There was an insignificant positive correlation between cTnT and LVMI (r=0.369, p=0.063). Albumin, cholesterol, LDL-cholesterol, and NT-proBNP had an independent effect on LVEF (R2=0.80). Age, body mass index, LDL-cholesterol, NT-proBNP, and cTnT had an independent effect on LVMI (R2=0.78).
Conclusion
BNP, NT-proBNP, and cTnT may be as a noninvasive diagnostic or prognostic marker of cardiac disease in stable hemodialysis patients.

Keyword

Hemodialysis; Natriuretic peptides; Troponin

MeSH Terms

Biomarkers
Body Mass Index
Brain*
Cholesterol
Coronary Artery Disease
Echocardiography
Heart Diseases*
Humans
Hypertrophy, Left Ventricular
Natriuretic Peptide, Brain*
Natriuretic Peptides
Plasma
Prevalence
Prospective Studies
Renal Dialysis*
Renal Insufficiency, Chronic
Stroke Volume
Troponin T*
Troponin*
Cholesterol
Natriuretic Peptide, Brain
Natriuretic Peptides
Troponin
Troponin T