THE VOLUME LOAD OF HEMODIALYSIS PATIENTS WITH END-STAGE RENAL DISEASE AND THE CLINICAL VALUE OF NT-PROBNP

Huahong Zhou¹, Yi Dong², Dong Cheng², Ting Zhang², Xujun Lang², Zhihao Yang², Xiaojun Fu^1,* 

¹Jinhua Hospital of Traditional Chinese Medicine, Jinhua, 321017, China - ²Department of Nephrology, Jinhua Hospital of Traditional Chinese Medicine, Jinhua, 321017, China

Objective: To analyze the volume load of end-stage renal disease (ESRD) hemodialysis (MHD) patients and the clinical value of N-terminal brain natriuretic peptide (NT-proBNP).

Methods: MHD patients were collected in our hospital from January 2019 to January 2020, and all patients were examined by ultrasound to detect the diameter of the inferior vena cava/body surface area (VCD) and were divided into non-high volume groups (VCD<11.5mm/m2, n=56) and high-volume group (VCD≥11.5mm/m2, n=41) according to the VCD level. Blood samples were collected from two groups of subjects before and after dialysis for 2 hours; NT-proBNP was detected through the immunoelectrochemiluminescence method; NT-proBNP levels of subjects were compared in each group; and Pearson linear correlation was used to analyze the correlation between NT-proBNP and VCD, ultrafiltration volume, and dry weight. The ROC curve was used to analyze the value of NT-proBNP in diagnosing ESRD patients with MHD not up to the ideal dry weight.

Results: The levels of NT-proBNP and VCD in the high-volume group were significantly higher than those in the non-high-volume group, and the difference was statistically significant (P<0.01). The levels of NT-proBNP and VCD in the high-volume group after adjusting the dry weight were significantly lower than those before adjusting the dry weight, and the difference was statistically significant (P<0.01). NT-proBNP has a significant positive correlation with VCD, ultrafiltration volume, and dry weight (r is 0.451, 0.352, 0.512, respectively; P values are all <0.05 or <0.01). The ROC curve analysis showed that the AUC of NT-proBNP for diagnosing ESRD patients with MHD who did not meet the ideal dry weight was 0.815, the sensitivity was 85.24%, and the specificity was 83.64%; the AUC for VCD diagnosis of ESRD patients with MHD who did not meet the ideal dry weight was 0.736, sensitivity of 75.16%, specificity of 72.15%.

Conclusion: The level of serum NT-proBNP in MHD patients is significantly high, and it is positively correlated with the patient’s VCD, ultrafiltration volume, and dry weight. NT-proBNP has certain value in diagnosing ESRD patients with MHD not reaching the ideal dry weight and could be widely used in clinical practice.