Cardiac biomarker indicates fluid overload in dialysis patients

May 27, 2010

Nephrologists must consider fluid overload effects when prescribing dialysis, according to a study appearing in an upcoming issue of the Clinical Journal of the American Society of Nephrology (CJASN). The fluid overload biomarker, N-terminal pro-brain-type natriuretic peptide (NT-pro-BNP), previously known as a “cardiac biomarker” in dialysis patients, is an important component of managing patients with kidney disease.

Fluid overload can cause misleading increases in body weight. “Assessment of dry or target weight is a fundamental concept in managing patients with end stage kidney disease, as volume overload leads to cardiac dysfunction and increased risk of death,” explains Andrew Davenport, MD (University College London Medical School). Dry weight is the patient’s weight without the extra fluid that builds up between sessions.

“Our study did not show any sustained association between NT-proBNP and cardiac function,” comments Davenport. The results contrast with previous studies suggesting that NT-proBNP might be a useful biomarker to predict increased risk of cardiovascular events and death in patients with . BNP is a produced by overworked or damaged heart ventricles and accompanied by the loss of sodium through urine. A biomarker is a that indicates progression of disease or response to medical therapy.

Dialysis patients with may still have high NT-proBNP levels, according to an accompanying editorial by Patrick S. Parfrey, MD (Memorial University, St. John’s, Newfoundland, Canada). However, when cardiac tests show normal heart function, “high BNP levels are likely the result of blood volume expansion, and require reduction in post dialysis dry weight,” Parfrey writes.

Though this “cardiac biomarker” now appears to be more closely related to fluid status than to heart function, an association with heart dysfunction was found in those who had a history of hypertension and were taking beta blockers. High NT-proBNP levels might also indicate malnutrition, another common problem in dialysis patients.

The researchers measured NT-proBNP levels after a dialysis session in 72 stable dialysis patients. The patients also underwent tests of . NT-proBNP levels were most associated with indicators of fluid overload. Maintaining proper fluid balance is one of the essential functions of dialysis. Excess fluid in the body―also called fluid overload or volume overload―can lead to the development of heart failure.

The study is limited by the fact that it was cross-sectional (all data collected at one time) rather than longitudinal (data collected over a period of time), according to Davenport.

Explore further: West Africa's Ebola outbreak prompts changes in I.Coast cuisine

More information: The article, entitled “N-terminal proBNP—Marker of Cardiac Dysfunction, Fluid Overload, or Malnutrition in Hemodialysis Patients?” (doi 10.2215/CJN.09001209) and editorial, entitled “BNP in Hemodialysis Patients” (doi 10.2215/CJN.02710310) will appear online on May 27, 2010.

add to favorites email to friend print save as pdf

Related Stories

Dialysis safe for kidney patients' heart health

Jul 09, 2009

Dialysis treatments do not affect the heart health of kidney disease patients who have had a heart attack, according to a study appearing in an upcoming issue of the Clinical Journal of the American Society Nephrology (CJASN ...

Low thyroid function common in chronic kidney disease

Jun 11, 2008

Many patients with chronic kidney disease (CKD) have mild reductions in thyroid function, or subclinical hypothyroidism—a condition that becomes more common as kidney function declines, according to a study in the September ...

Sleeping through dialysis: No nightmare for kidney patients

May 21, 2009

Dialysis takes hours of kidney disease patients' time several days a week, so why not do it at night while sleeping? Overnight dialysis is more convenient for some patients and offers significant benefits over shorter daytime ...

Recommended for you

Two expats die of MERS in Saudi commercial hub

18 hours ago

Two foreigners died of MERS in the Saudi city of Jeddah, the health ministry said Saturday, as fears rise over the spreading respiratory virus in the kingdom's commercial hub.

UAE reports 12 new cases of MERS

18 hours ago

Health authorities in the United Arab Emirates have announced 12 new cases of infection by the MERS coronavirus, but insisted the patients would be cured within two weeks.

Filipino tests negative for Middle East virus

Apr 19, 2014

A Filipino nurse who tested positive for the Middle East virus has been found free of infection in a subsequent examination after he returned home, Philippine health officials said Saturday.

User comments : 0

More news stories

Cancer stem cells linked to drug resistance

Most drugs used to treat lung, breast and pancreatic cancers also promote drug-resistance and ultimately spur tumor growth. Researchers at the University of California, San Diego School of Medicine have discovered ...

Making graphene in your kitchen

Graphene has been touted as a wonder material—the world's thinnest substance, but super-strong. Now scientists say it is so easy to make you could produce some in your kitchen.