Evgenija Homsak
University Clinical Centre Maribor,Slovenia
Title: Hemodiafiltration affects NT-proBNP but not ST2 serum concentration in end-stage renal disease patients
Biography
Biography: Evgenija Homsak
Abstract
Background: Amino-terminal pro-B-type natriuretic peptide (NT-proBNP) is already established and soluble ST2 (sST2) is a new promising marker for evaluating and monitoring patients undergoing hemodiafiltration (HDF) who are at increased risk for cardiovascular events. Although HDF is known to affect the concentration of some biochemical parameters, the exact effect on the concentration of sST2 has not yet been studied. The aim of this study was to assess the effect of HDF on serum sST2 and NT-proBNP concentrations in End-stage Renal Disease (ESRD) patients.
Methods: sST2 and NT-proBNP were measured in serum samples from 55 patients with ESRD before and after HDF (F5008 Dialysis machines, Fresenius Medical Care, Milsons Point NSW, Australia), using an ELISA method: Presage ST2 Assay (Critical Diagnostics, San Diego, CA, USA) and a one-step sandwich chemiluminescent immunoassay for NT-proBNP based on LOCI technology (Dimension Vista System 1500, Siemens Healthcare Diagnostics Inc., Newark, NJ, USA), respectively.
Results: The median (interquartile range) NT-proBNP concentration decreased from 728 (332-2832) to 256 (140-813) pmol/L after HDF (P < 0.001). The mean individual decrease was -62.8 12.9 % with a minimum of -29.1% and maximum of -97.6%. Concentration of sST2 remained unchanged after HDF (median (interquartile range): 28.0 (24.0-33.1) ng/mL and 28.0 (22.0-33.1) ng/mL before and after, respectively; P=0.579).
Conclusions: There is a significant decrease of NT-proBNP after HDF, whereas sST2 remains unaffected by HDF. Care should be taken when interpreting NT-proBNP results having regard to the time since last dialysis. sST2 measurement can be done any time, irrespective of the HDF procedure.