The Value Of BNP For Evaliating The Cardiac Function Of Patients With Chronic Renal Failure

ObjectiveStudy chronic renal failure patients serum B– type natriuretic peptide (BNP) concentration in different renal function and grading NYHA of change characteristics and their relationship with BNP concentration, analyzes the related echocardiography parameters relationship.Methods:Choose the CRF patients hospitalized 75 cases, determine the echocardiography parameters, the serum creatinine BNP concentration, according to China's improved MDRD formula in the glomerular filtration rate, according to K/DOQI guide 2003 edition divide the sample into standard CKD3, 4, and 5 (including not dialysis, hemodialysis, peritoneal dialysis ) period five groups were compared; According to the American New York heart association (NYHA) made the sample into NYHAⅠ,Ⅱ,Ⅲ,Ⅳgrade four groups were compared. Respectively comparing different kidney level, different cardiac level of BNP concentration differences; Compare the different level of cardiac function with the same renal level differences of BNP concentration; Compare the different renal levels with the same cardiac function differences of BNP concentration; Compare the relationship between BNP concentration and the echocardiography parameters such as EF,IVS,LVPW,LV,LA,RV.Results1. The blood BNP concentration in different kidney level CKD3, 4, 5 patients has no obvious difference (P≥0.05). The blood BNP concentration of CKD5 period in not dialysis, hemodialysis, peritoneal dialysis patients has no obvious difference (P≥0.05). 2. The blood BNP concentration in different cardiac functionⅠ,Ⅱ,Ⅲ,Ⅳlevel patients exists significant difference (P < 0.01). 3. The blood BNP concentration in different NYHA level with the same kidney level has obvious difference (P < 0.01); The BNP concentration in different kidney level with the same NYHA level has no obvious difference (P≥0.05). 4. Blood BNP concentration has negative correlation with echocardiography parameters EF (r=-0.826,P<0.01), positive correlation with IVS(r=0.265,P<0.01),with LVPW(r=0.681,P<0.01), and no relation with LV, LA, RV (P≥0.05).Conclusions1. If GFR < 60ml/min/1.73cm~2, the blood BNP concentration has no relation with the kidney function, and positive relation with the severity of heart failure. 2. In the same kidney function, the higher NYHA level, the higher blood BNP concentration. 3. The blood BNP concentration has relationship with echocardiography parameters such as LVEF. 4. In clinical, we can judge the cardiac function of the patients with chronic renal failure through the inspection of blood BNP concentration.