ABSTRACT
Objective To investigate the value of plasma N terminal brain natriuretic peptide (NT-BNP) in dialysis adequacy assessment of maintenance hemodialysis (MHD).Methods One hundred and twelve MHD patients were divided into hemodialysis adequacy group (group A,63 patients,cardiothoracic ration ＜0.5) and hemodialysis inadequate group (group B,49 patients,cardiothoracic ration ≥ 0.5).The plasma NT-BNP levels of pre-dialysis,dialysis end,4th and 24th hour after dialysis were compared.Before and after dialysis the inferior vena cava diameter (VCD) was checked.The correlation between NT-BNP level at the end of dialysis,cardiothoracic ration and post dialysis VCD were analyzed.Results The levels of NT-BNP in group A,B before dialysis were(13 808 ± 7611) and (25 573 ± 8444)ng/L respectively,and there was significant difference (P ＜ 0.01).The levels of NT-BNP in two groups increased at the end of dialysis,but there was no significant difference (P ＞0.05).Then the levels of NT-BNP in two groups decreased significantly at 4th hour after dialysis (P ＜ 0.01).The levels of NT-BNP in two groups at 4th hour after dialysis were (8256 ±6611) and (21 320 ±6828) ng/L,and there was significant difference (P＜ 0.01).At 24th hour after dialysis,the level of NT-BNP in group A was still at a low level,but in group B,the level of NT-BNP increased again.Before dialysis,the levels of VCD between two groups had no significant difference (P ＞ 0.05).After dialysis,the level of VCD in group B decreased significantly(P ＜ 0.05).After dialysis,the level of VCD in group B was significantly higher than that in group A(P＜ 0.05).The level of NT-BNP had positive relationship with cardiothoracic ration and VCD (r =0.462,P＜ 0.01 ;r =0.513,P＜ 0.01).Conclusion The level of NT-BNP can reflect the volume overload and urea clearance index of MHD,which may be a more comprehensive evaluation index of the adequacy of dialysis.