Influence of cardiac diseases on plasma brain natriuretic peptide level in chronic hemodialysis and kidney transplant patients /
ى ادرار ا (- إن- ) ت ا ي ار اي ت ا و زرع ا
Rasha Ahmed Darwish ; Supervised Mohamed Hany Hafez , Alaa Abdelhameed , Eman Farouk Ramzy
- Cairo : Rasha Ahmed Darwish , 2015
- 206 P. : charts , facsimiles ; 25cm
Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Internal Medicine
OBJECTIVE : To evaluate how the cardiac Biomarker N-terminal pro-brain natriuretic peptide may be utilized in predicting cardiovascular disease and outcome stratification in CKD and renal transplantation patients. Also, to define the best cut off reference value of NT pro-BNP in this category of patients in specific cardiac pathologies. METHODS: Case control study including 10 non-cardiac hemodialysis patients, 20 maintenance hemodialysis patients known to have cardiac diseases and in 15 renal transplantation patients who were on hemodialysis. We measured the level of NT-Pro BNP and Echocardiogram was performed in all of them. Inferior vena cava diameter (IVCD) measurement by ultrasonography was done being a non-invasive tool for estimation of fluid status as it reflects intravascular volume changes. RESULTS : The raised levels of the Pro-BNP in the HDX cardiac was about 4 folds higher than the HDX non-cardiac controls, while it was 2 folds higher in the TX group compared to the control group. The NT-pro BNP in the three groups is elevated more than 10 fold the upper limit of normal. NT- pro BNP may be of help in the detection of the presence of cardiac diseases in hemodialysis when ranging from 4,000-4,500 ng/L. systolic dysfunction presence with an almost 70% specificity when its value was above 5,500 ng/L . In Transplantation, detection of cardiac cases if the cut-off value of 3,85 2.50 ng/L with 80% specificity. Also, the level of 4,500 ng/L could be used for doubting the presence of ventricular hypertrophy in TX. CONCLUSION : Renal transplantation reduces the risk of cardiovascular disease in comparison with dialyzed patients, but it still remains higher than in healthy people. NT-pro BNP cutoff limits can help in early detection of cardiac diseases in general in both Hemodialysis and transplantation patients