CHANGES OF PLASMA ATRIAL AND BRAIN NATRIURETIC PEPTIDE LEVELS DURING HEMODIALYSIS

Objectives. The purpose of this study was to evaluate the effect of he modialysis on the plasma concentration of atrial and brain natriuretic peptides, and to determine the two-dimensional echocardiographic para meters affecting the changes of plasma atrial and brain natriuretic pe ptide levels in patients with chronic renal failure. Background. Brain natriuretic peptide has been found in human cardiac tissue and increa ses in patients with congestive heart failure. However the factors tha t stimulate the secretion of plasma brain natriuretic peptide have not yet been fully clarified. Methods. In 15 patients with chronic renal failure, plasma atrial and brain natriuretic peptide levels and two-di mensional echocardiographic parameters were measured before and after each session of hemodialysis. Results. Plasma atrial natriuretic pepti de levels significantly decreased from 367 +/- 537 pg/mL to 138 +/- 16 7 pg/mL after hemodialysis (p < 0.01). However plasma brain natriureti c peptide levels did not significantly change after hemodialysis. Left atrial dimension signlficantly decreased (41.1 +/- 6.6 vs. 36.3 +/- 6 .2 mm, p < 0.01) and left ventricular end-diastolic dimension slightly decreased after hemodialysis (57.0 +/- 10.3 vs. 55.7 +/- 9.9 mm, p < 0.05). The decrease of left atrial dimension was greater than that of left ventricular end-diastolic dimension (4.9 +/- 1.6 vs. 1.3 +/- 0.6 mm, p < 0.05). Plasma brain natriuretic peptide levels significantly c orrelated with fractional shortening both before and after hemodialysi s (r = 0.65, p < 0.05). Conclusion. Plasma atrial natriuretic peptide levels significantly decreased as the right and left atrial overloads decreased, and plasma brain natriuretic peptide levels did not signifi cantly decrease after hemodialysis. Plasma brain natriuretic peptide l evels were not significantly influenced by acute hemodynamic change, s uch as hemodialysis. However plasma brain natriuretic peptide levels w ere significantly correlated with basic cardiac function.