CHEN Sheng-fang,CUI Chun-li,MA Jun,et al.Association of serum NT-pro-BNP levels with nutritional status, residual kidney function and dialysis adequacy in patients undergoing peritoneal dialysis[J].同济大学学报（医学版）,2012,33(4):63-67. [点击复制]
Association of serum NT-pro-BNP levels with nutritional status, residual kidney function and dialysis adequacy in patients undergoing peritoneal dialysis
Objective To investigate the association of serum N -terminal pro -brain natriuretic peptide (NT -pro-BNP) levels with nutritional status, residual kidney function and dialysis adequacy in patients undergoing continuous ambulatory peritoneal dialysis (CAPD) . Methods Fifty eight clinically stable patients undergoing CAPD were enrolled in the study ； subjects with no heart and renal diseases served as control group A and uremic patients without dialysis as control group B. Serum NT -pro-BNP concentrations were measured in CAPD patients and control groups. The indices of dialysis adequacy, residual renal function and nutritional status were assessed in CAPD patients; and other biochemical parameters were also examined. Results Serum NT-pro-BNP levels in CAPD patients and in control group B were markedly higher than those in control group A (z=-7.653, z=-6.535； P＜0.001), there was no significant difference between CAPD patients and control group B (z=-0.731, P=0.465) . Correlation analysis showed that BMI, MAMC, ALB and TSF were negatively correlated with serum NT-pro-BNP levels in all patients (r=-0.304, P=0.020; r=-0.385, P=0.003; r=-0.308, P=0.028 ； r=-0.333, P=0.017) , and SGA was positively correlated with NT-pro-BNP (r=0.361, P=0.007) . In CAPD patients urine volume, rGFR, residual renal Kt/V, total Kt/V, residual renal Ccr and total Ccr were negatively correlated with NT-pro-BNP levels (r=-0.504, P＜0.001； r=-0.616, P＜0.001； r=-0.573, P＜0.001 ； r=-0.331, P=0.020； r=-0.616, P＜0. 001 ； r=-0.598, P＜0.001) . Patients with Kt/v ≥2.0 tended to have lower serum NT-pro-BNP levels than those with Kt /v ＜ 2.0, but the difference was not statistically significant (z=-1.061, P=0.289) . Patients with total Ccr≥60 L/week had lower serum NT-pro-BNP level than those with total Ccr ＜60 l/week/1. 73 m2 patients (z=-3.248, P=0.001) . Multivariate regression analysis revealed that quantitative SGA score and residual renal Ccr were independent risk factors for serum NT-pro-BNP levels (β=0.313, P=0.015; β=-0.418, P=0.002) . Conclusion Our data suggest that nutritional status, residual renal function and dialysis adequacy are closely associated with NT-pro-BNP in CAPD patients. Malnutrition and reduced residual renal function are independent risk factors for serum NT-pro-BNP levles.
