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[Determination of brain natriuretic peptide in patients undergoing different haemodiafiltration techniques]. / Determinación del péptido natriurético cerebral en pacientes sometidos a diferentes técnicas de hemodiafiltración.

UNLABELLED: IB-type natriuretic peptide is a cardíac neurohormone secreted by the cardíac ventricules in response to ventricular dilatation so plasma BNP level correlate with left ventricular mass and dysfunction. Dialysis patients have much greater levels of BNP due to the volume overload and because of reduced renal clearance. The aim of this study was to mesure and compare the BNP levels in three groups of patients who received different hemodiafiltration techniques: Daily online hemodiafiltration (HDFOLd), on-line hemodiafiltration (HDFOL) and low convective volume hemodiafiltration (HDF). Fifteen patients were included, five in each group. Pre and postdialysis BNP leves were measured during 8 weeks. The measure was done at the beginning of the week (long period), and at the end (short period), in order to study if there were significative differences between techniques and periods. We found significative differences between predialysis BNP levels in the short period (BNPpreC) and the long period (BNPpre-L). We also found significative differences with the posdialysis BNP in both periods; BNPpre- L vs. BNPpos-L (1069+/-1031 vs. 612 +/- 540). After comparing the three techniques the study showed significative differences between BNPpreC in HDF and HDFOL compared with HDFOld. And also after dialysis between BNPpos-C in HDFOLd compared with the other techniques. CONCLUSION: Although previous papers have shown that BNP levels have limited potential for assessment of hydration in hemodialysis patients, in this study our data demonstrate that after dialysis BNP levels decline in a significative way in the long and short period and we have found that patients on daily hemodialysis show lower BNP levels, and maybe this could be explained because daily on-line haemodiafiltration patients had lower weight rise between dialysis sessions and also better haemodynamic tolerance.

Determinación del péptido natriurético cerebral en pacientes sometidos a diferentes técnicas de hemodiafiltración / No disponible

El péptido natriurético cerebral (BNP) es una hormona que se libera a la circulación en respuesta de dilatación ventricular. Sus niveles se correlacionan con la masa del ventrículo izquierdo y con la disfunción ventricular. Los pacientes en diálisis presentan valores elevados a consecuencia de la situación de expansión de volumen y la reducción de su aclaramiento. Objetivo: analizar los niveles de BNP en pacientes sometidos a diferentes técnicas de hemodiafiltración: on-line diaria (HDFOLd), on-line (HDFOL) y con bajo volumen convectivo (HDF). Se determinaron las concentraciones séricas pre y posdiálisis de 15 pacientes (cinco de cada grupo) durante ocho semanas. Se efectuaron dos determinaciones, una a principio de semana (período largo) y otra al final de semana (período corto), con el fin de determinar si existían diferencias significativas entre técnicas y entre períodos. Al comparar los valores globales de BNP prehemodiálisis entre el período corto (BNPpreC) y el largo (BNP pre-L), se objetivaron diferencias significativas. Igualmente, se apreciaron diferencias entre el BNPpos del período corto y del largo. Asimismo, entre el BNP preC vs. BNPpos-C y entre BNPpre-L vs. BNPpos-L. El estudio comparativo entre técnicas mostró diferencias significativas en el período corto entre el BNPpre-C y BNPpos-C de HDFOLd con respecto a las mismas determinaciones en HDF y HDFOL. Conclusión: aunque la determinación del BNP tiene un potencial limitado para la evaluación del estado de hidratación en los pacientes en hemodiálisis, en este trabajo hemos comprobado que tras la sesión de diálisis se produce un descenso significativo del BNP, tanto en el período corto como en el largo, y que de manera significativa los pacientes del grupo de diaria presentan concentraciones inferiores de BNP, lo que se explicaría por la menor ganancia de peso interdiálisis y la mejor tolerancia hemodinámica a la técnica (AU)

IB-type natriuretic peptide is a cardíac neurohormone secreted by the cardíac ventricules in response to ventricular dilatation soplasma BNP level correlate with left ventricular mass and dysfunction. Dialysis patients have much greater levels of BNP due to the volume overload and because of reduced renal clearance. The aim of this study was to mesure and compare the BNP levels in three groups of patients who received different hemodia filtration techniques: Daily on-line hemodiafiltration (HDFOLd),on-line hemodiafiltration (HDFOL) and low convective volume hemodiafiltration (HDF). Fifteen patients were included, five ineach group. Pre and postdialysis BNP leves were measured during 8 weeks. The measure was done at the beginning of the week (long period), and at the end (short period), in order to study if there were significative differences between techniques and periods. We found significative differences between predialysis BNP levels in the short period (BNPpreC) and the long period (BNPpre-L). We also found significative differences with the posdialysis BNP in both periods; BNPpre-L vs. BNPpos-L(1069±1031 vs. 612 ± 540). After comparing the three techniques the study showed significative differences between BNPpreC in HDF and HDFOL compared with HDFOld. And also after dialysis between BNPpos-C in HDFOLd compared with the other techniques. Conclusion: Although previous papers have shown thatBNP levels have limited potential for assessment of hydration in hemodialysis patients, in this study our data demonstrate thatafter dialysis BNP levels decline in a significative way in the long and short period and we have found that patients on daily hemodialysis show lower BNP levels, and maybe this could be explained because daily on-line haemodiafiltration patients had lower weight rise between dialysis sessions and also better haemodynamic tolerance (AU)

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