Abstract:

ABSTRACT     Objective To investigate the serum level of amino-terminal pro-B-natriuretic peptide (NT-proBNP) and its relationship with cardiovascular disease (CVD) and malnutrition in maintenance hemodialysis(MHD) patients. Methods Blood samples were obtained from one hundred thirty MHD patients before undergoing hemodialysis. The serum NT-proBNP was measured by electro-chemoluminiscence immunoassay. Spearman correlation and linear regression were used to assess the correlation between NT-proBNP and other parameters. Receiver operating characteristic (ROC) curves were used to assess the relationship with NT-proBNP, cardiac troponin T(cTnT), high-sensitive C reactive protein (hsCRP) and left ventricular hypertrophy. Results: The levels of serum NT-proBNP were significantly higher in MHD patients, the patients with CVD had more higher serum NT-proBNP levels than that those without CVD（4649 [2920-14069]pg/ml vs 3006 [1457-7478]pg/ml，P=0.002）. In all MHD patients, serum NT-proBNP was correlated positively with age（ρ=0.195，P=0.026）, systolic blood pressure (ρ=0.306，P=0.001), hsCRP (ρ=0.228，P=0.009), cTnT (ρ=0.448，P<0.001), carotid artery intima-media thickness (ρ=0.244，P=0.021) and left ventricular mass index (ρ=0.537，P<0.001); while negatively with body mass index (ρ=-0.153，P=0.031), pre-albumin (ρ=-0.304，P<0.001), triglyceride (ρ=-0.246，P=0.014), total cholesterol (ρ=-0.265，P=0.008), low density lipoprotein cholesterol（ρ=-0.254，P=0.012）and left ventricular ejection fraction（ρ=-0.194，P=0.040）. Linear regression analysis showed that cTnT (β=0.463，P=0.001), left ventricular mass index (β=0.324，P=0.003) and systolic blood pressure(β=0.208，P=0.008) were independently associated with NT-proBNP. ROC curves analysis showed that the relationship between NT-proBNP and left ventricular hypertrophy was more closely than that cTnT and hsCRP. Conclusions Serum NT-proBNP is markedly elevated in MHD patients, which is associated with CVD and malnutrition.

Key words: hemodialysis, amino-terminal pro-B-natriuretic peptide, cardiovascular disease, left ventricular hypertrophy