Investigational Biomarkers in Patients with Chronic Renal Failure
Journal Title: Eastern Journal of Medical Sciences - Year 2018, Vol 3, Issue 4
Abstract
Background: Several studies showed that urinary concentration of neutrophil gelatinase-associated lipocalin (NGAL) increased in patients with chronic heart failure and mildly reduced glomerular filtration rate (GFR). Objective: To compare the NGAL levels between patients with high N-terminal pro-brain natriuretic peptide (NT-proBNP) levels and those with low NT-proBNP levels. Methods: In this case control study, we estimated the GFR, NT-proBNP, NGAL and fibroblast growth factor 23 (FGF- 23) levels in twenty peritoneal dialysis patients, along with twenty age- and sex-matched healthy controls. Therefore, in patients with NT-proBNP levels higher than 1000 pg/mL (hypervolemic patients) and in patients with NT-proBNP lower than 1000 pg/mL (normovolemic patients), serum NGAL and parameters of echocardiography were evaluated at the beginning of the study and again after three months. Results: In this study, patients’ serum NT-proBNP levels, NGAL and FGF23 were significantly higher than in the healthy control group (p <0.05). There were no significant differences between hypervolemic patients and normovolemic patients with regard to age, sex, body mass index, serum creatinine, parathyroid hormone, blood urea nitrogen (BUN), urine volume, GFR and left ventricular end-diastolic diameter, left atrial diameter or aortic root size measured by echocardiographic evaluation at the beginning and at the second measurement (p >0.05). Plasma NT-proBNP levels were markedly greater in hypervolemic patients (13323.3±11235.9 pg/mL) than those of normovolemic patients (456.1±266.7 pg/mL) (p <0.05). In hypervolemic patients, there was a significant decrease in NT-proBNP levels at the second measurement (from 13323.3±11235.9 pg/mL to 9667.3±9483.2 pg/mL) (p <0.05). However, no significant changes were detected in serum NGAL levels, FGF23 or GFR. In normovolemic patients, serum NT-proBNP, NGAL, FGF23 and GFR did not change (p >0.05). Conclusion: Serum NT-proBNP, NGAL and FGF23 levels are significantly higher in dialysis patients. This further indicates the need for a more comprehensive study of hypervolemia and the reduction of NGAL and residual renal function, which we often encounter in patients with renal insufficiency.
Authors and Affiliations
Derya Sahin, Hulya Taskapan
Keywords
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