Abstract
It is difficult to evaluate heart failure in hemodialysis patients because of high concentrations of BNP and NT-proBNP. The concentration changes of these peptides were measured in 26 hemodialysis patients from post-hemodialysis on the weekend to pre-hemodialysis at the beginning of the next week. The time course of NT-proBNP after hemodialysis completely corresponded to the logarithmic curve. Therefore, NT-proBNP kinetic analysis was performed using the single-compartment model and the elimination rate constant and half-life were determined. The elimination rate constant was estimated using NT-proBNP, body mass index (BMI) and estimated glomerular filtration rate (eGFR) using multiple regression analysis. The half-lives of NT-proBNP and BNP were 15.3±2.7 hours and 27.2±10.5 minutes, respectively. The BNP half-life got shorter in association with the severity of heart failure, but there was no significant change in the NT-proBNP half-life. This study indicates the formula for conversion between the NT-proBNP in hemodialysis patients and that in individuals with normal renal function. The converted NT-proBNP has a good relationship with the evaluation of heart failure by echocardiography. Thus, it is possible to evaluate heart failure by using NT-proBNP in hemodialysis patients as in individuals with normal renal function.
