Brain natriuretic peptide in peritoneal dialysis patients

Abstract

Background: The expanding use of brain natriuretic peptides (BNP and NT-proBNP) testing in patients with end-stage kidney disease has increased our knowledge of relating heart-kidney interactions, but also brought concern of the reliability and usefulness of BNPs in dialysis patients.

Methods: The review highlights the most important recent results of BNP research and discusses applicability of BNPs in the evaluation of peritoneal dialysis (PD) patients.

Results: Relevant physiological background of BNP with relating aspects of PD treatment are reviewed, along with analysis of BNP measurement limitations and suggestions for rational use in the PD population.

Conclusion: To date, interpretation of BNP levels in PD patients is limited in areas of hydration status assessment and optimal dry weight determination. However, elevated levels of BNPs exhibit validated correlation and prognostic value with pathological cardiac structure, cardiovascular adverse events and survival, thus assisting in individual patient risk profiling and deeper understanding of cardiorenal factors involved.