SERUM BNP CONCENTRATION AND LEFT VENTRICULAR MASS IN CAPD AND AUTOMATED PERITONEAL DIALYSIS PATIENTS

• Published in: Peritoneal dialysis international 2007-11, Vol.27 (6), p.663-668
• Main Authors: Bavbek, Nuket, Akay, Hatice, Altay, Mustafa, Uz, Ebru, Turgut, Faruk, Uyar, Mehtap E, Karanfil, Aydyn, Selcoki, Yusuf, Akcay, Ali, Duranay, Murat
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Cross-Sectional Studies; Dialysis Solutions - administration & dosage; Echocardiography; Emergency and intensive care: renal failure. Dialysis management; Female; Glomerulonephritis; Glucans - administration & dosage; Glucose - administration & dosage; Heart Ventricles - pathology; Humans; Hypertrophy, Left Ventricular - diagnosis; Hypertrophy, Left Ventricular - etiology; Icodextrin; Intensive care medicine; Kidney Failure, Chronic - blood; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - therapy; Male; Medical sciences; Middle Aged; Natriuretic Peptide, Brain - blood; Nephrology. Urinary tract diseases; Nephropathies. Renovascular diseases. Renal failure; Peritoneal Dialysis - methods; Peritoneal Dialysis, Continuous Ambulatory; Ultrafiltration; Water-Electrolyte Imbalance
• ISSN: 0896-8608; 1718-4304
• DOI: 10.1177/089686080702700612

Department of Nephrology, 1 Fatih University Medical School; Department of Nephrology, 2 Ankara Education and Research Hospital; Department of Internal Medicine 3 and Department of Cardiology, 4 Fatih University Medical School, Ankara, Turkey Correspondence to: N. Bavbek, Harbiye Mah, Nigde Sokak, 46/2 Dikmen, Ankara, Turkey. ntbavbek{at}yahoo.com Objective: To compare ultrafiltration under continuous ambulatory peritoneal dialysis (CAPD) and automated PD (APD), disclosing potential effects on serum B-type natriuretic peptide (BNP) levels and echocardiographic findings. Patients and Methods: This cross-sectional clinical study included 32 patients on CAPD and 30 patients on APD without clinical evidence of heart failure or hemodynamically significant valvular heart disease. Peritoneal equilibration tests, BNP levels, and echocardiographic measurements were performed in each subject. BNP measurements were also performed in 24 healthy control subjects. Results: Patients on APD had lower ultrafiltration and higher values of BNP and left ventricular mass index (LVMI) compared with patients on CAPD (respectively: 775 ± 160 vs 850 ± 265 mL, p = 0.01; 253.23 ± 81.64 vs 109.42 ± 25.63 pg/mL, p = 0.001; 185.12 ± 63.50 vs 129.30 ± 40.95 g/m 2 , p = 0.001). This occurred despite higher mean dialysate glucose concentrations and far more extensive use of icodextrin in the APD group. Conclusion: Treatment with APD is associated with higher plasma BNP levels and LVMI compared to CAPD. This may be the result of chronic fluid retention caused by lower ultrafiltration in APD patients. KEY WORDS: CAPD; APD; ultrafiltration; B-type natriuretic peptide (BNP); left ventricular mass index. Received 2 March 2007; accepted 24 May 2007.