Myocardial markers are highly altered by higher rates of fluid removal during hemodialysis

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Hemodialysis International Pub Date : 2023-10-24 DOI:10.1111/hdi.13124

Junko Goto, Michael Ott, Bernd Stegmayr

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引用次数: 0

Abstract

Introduction

Although hemodialysis is lifesaving in patients with kidney failure extensive interdialytic weight gain (IDWG) between dialyses worsens the prognosis. We recently showed a strong correlation between IDWG and predialytic values of cardiac markers. The aim of the present study was to evaluate if the cardiac markers N-terminal pro-B-type natriuretic peptide (proBNP) and troponin T were influenced by IDWG and speed of fluid removal (ultrafiltration-rate).

Methods

Twenty hemodialysis patients performed in total 60 hemodialysis (three each). Predialytic values of proBNP and troponin T and changes from predialysis to 180 min hemodialysis (180–0 min) were compared with the IDWG calculated in percent of body weight. The ultrafiltration-rate was adjusted (UF-rate_adj) to IDWG: (100 × weight gain between dialysis [kg])/(estimated body dry weight [kg] × length of hemodialysis session [hours]).

Results

UF-rate_adj correlated (Spearman) with (1) predialytic values of IDWG (r = 0.983, p < 0.001), proBNP (r = 0.443, p < 0.001), and troponin T (r = 0.296, p = 0.025); and (2) differences in proBNP_180–0min (r = 0.572, p < 0.001) and troponin T_180–0min (r = 0.400, p = 0.002). UF-rates_adj above a breakpoint of 0.60 caused more release of proBNP_180–0min (p = 0.027). Remaining variables in multiple regression analysis with ProBNP_180–0min as dependent factor were predialytic proBNP (p < 0.001) and the ultrafiltration-rate (p < 0.001).

Conclusion

Higher UF-rate_adj during dialysis was correlated to increased levels of cardiac markers. Data support a UF-rate_adj lower than 0.6 to limit such increase. Further studies may confirm if limited fluid intake and a lower UF-rate_adj should be recommended to prevent cardiac injury during dialysis.

Abstract Image

查看原文本刊更多论文

在血液透析期间，较高的液体排出率会使心肌标志物发生高度改变。

引言：尽管血液透析可以挽救肾衰竭患者的生命，但透析之间的大量分析间体重增加（IDWG）会恶化预后。我们最近发现IDWG和心脏标志物的分析前值之间有很强的相关性。本研究的目的是评估心脏标志物N-末端B型钠尿肽原（proBNP）和肌钙蛋白T是否受到IDWG和排液速度（超滤率）的影响。方法：20名血液透析患者共进行了60次血液透析（各3次）。BNP和肌钙蛋白T的透析前值及从透析前到180的变化最低血液透析（180-0 min）与以体重百分比计算的IDWG进行比较。将超滤速率（UF rateadj）调整为IDWG:（100 × 透析之间的体重增加[kg]）/（估计身体干重[kg] × 结果：UF比率adj（Spearman）与（1）IDWG的分析前值（r = 0.983，p 180-0分钟（r = 0.572，p 180-0分钟（r = 0.400，p = 0.002）。高于0.60断点的UF速率sadj导致proBNP180-0min的更多释放（p = 0.027）。以ProBNP180-0min为因变量的多元回归分析中的剩余变量为分析前的proBNP（p 结论：透析过程中UF率升高与心脏标志物水平升高有关。数据支持UF比率adj低于0.6以限制这种增长。进一步的研究可能会证实，是否应该建议限制液体摄入和降低UF率，以防止透析过程中的心脏损伤。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hemodialysis International UROLOGY & NEPHROLOGY-

CiteScore

2.50

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Hemodialysis International was originally an annual publication containing the Proceedings of the International Symposium on Hemodialysis held in conjunction with the Annual Dialysis Conference. Since 2003, Hemodialysis International is published quarterly and contains original papers on clinical and experimental topics related to dialysis in addition to the Annual Dialysis Conference supplement. This journal is a must-have for nephrologists, nurses, and technicians worldwide. Quarterly issues of Hemodialysis International are included with your membership to the International Society for Hemodialysis. The journal contains original articles, review articles, and commentary to keep readers completely updated in the field of hemodialysis. Edited by international and multidisciplinary experts, Hemodialysis International disseminates critical information in the field.