The Level Of Serum B-type Natriuretic Peptide And The Indices Of Oxidative Stress In Continuous Ambulatory Peritoneal Dialysis Patients

Objective: To observe the correlation of serum brain natriuretic peptidelevels and the indices of oxidative stress: MDA, SOD, AOPP in thecontinuous ambulatory peritoneal dialysis patients.Methods:(1)81CAPD(continuous ambulatory peritoneal dialysis)patien-ts which regularly following up in nephrology department more than3monthsin a stable condition, with39males and42females, aged14-80, average age45.32±13.59years were selected. Primary disease included chronicglomerulonephritis60cases, diabetic nephropathy4cases, chronic interstitialnephritis1cases, lupus nephritis1cases, the reasons unknown15cases.12cases (5males,7females) were collected as the normal control group.(2)Enzyme linked immuno sorbent assay (ELISA) was applied to detect theserum levels of BNP and the levels of advanced oxidation protein product(AOPP). Xanthine oxidase method was used for determination of serumlevels of SOD, with sulfur and barbituric acid reaction method was used fordetermination of serum levels of MDA（.3）the general information of patientswere recorded. the relationship of the serum BNP levels and the indices ofoxidative stress and clinical indicators [age, gender, body mass index(BMI),blood pressure, cholesterol, blood albumin(ALB), hemoglobin(HB), bloodurea nitrogen (BUN), serum creatinine(Scr)), hypersensitive c-reactive protein(HsCRP), calcium (Ca), phosphorus (P), the residual renal function(RRF), thetotal urea clearance (KT/V)]were analysised in continuous ambulatoryperitoneal dialysis patients.(4) conform to the normal distribution of clinicalindicators and experimental data with X±s, do not accord with normal—distribution data with median, the relationship of BNP and the indices ofoxidative stress uses nonparametric rank and inspection. Spearman correlation was used to determine the relationship between BNP and clinical indices.SPSS13.0statistical software was used to analyze the above-mentioned data,in which process the significance was set at P<0.05.Results：1The serum levels of BNP in continuous ambulatory peritoneal dialysispatientsThe levels of BNP in continuous ambulatory peritoneal dialysis patientswere increased significantly compared to the control group[158.71(33.64～2450.64) vs67.24(29.2～130.85)]pg/ml(P<0.05)。2The index of oxidative stress in continuous ambulatory peritoneal dialysisgroupThe levels of MDA in continuous ambulatory peritoneal dialysis groupwere obviously higher than the normal control group,(5.80±1.21vs3.34±0.71) umol/ML,(P<0.01). The levels of AOPP in peritoneal dialysis groupwere significantly higher compared to the normal control group (141.13±42.83vs84.76±29.01)pmol/L (P<0.01). The levels of SOD in peritoneal dialysisgroup were significantly reduced compared to the normal control group(64.30±26.95vs88.34±15.58)U/ML (P<0.01).3The relationships between the serum levels of BNP and the indices of theoxidative stressAccording to the serum levels of BNP, there were four groups in thecontinuous ambulatory Peritoneal dialysis: the group of BNP<100pg/mlwith19cases(23.46％), BNP100～200pg/ml with34cases（41.98％）,BNP200～400pg/ml with15cases（18.52％）and BNP>400pg/ml with13cases（16.05％）.4The levels of oxidative stress in different BNP groups of the continuousambulatory peritoneal dialysis group4.1The levels of MDA in group of BNP100～200pg/ml are higher than that ofthe group of BNP<100pg/ml, the results were as follows (5.95±1.21vs5.28±1.17) umol/ML (P<0.05); The levels of MDA in group of BNP200～400pg/ml are higher than that of the group of BNP<100pg/ml, the results were as follows(5.71±0.79vs5.28±1.17)(P<0.05);The levels of MDA ingroup of BNP>400pg/ml were increased significantly compared to the groupof BNP<100pg/ml, the results were as follows (7.26±1.47vs5.28±1.17)umol/ML (P<0.05).Compared to the levels of MDA in the other PD groups, nosignificantly difference was found between the two groups.4.2Compared to the levels of SOD, no significantly difference was found indifferent BNP groups. The levels of SOD in each BNP groups were lowerthan that in the normal control group, the results were significant(P<0.05).4.3There were significantly difference compared to the levels of AOPP in thegroups of BNP>400pg/ml and the groups of BNP200～400pg/ml, the groupof BNP100～200pg/ml, the group of BNP<100pg/ml,the results were asfollows(176.63±41.90vs144.69±37.87，176.63±41.90vs132.86±42.82，176.63±41.90vs128.82±35.99)pmol/L (P<0.05).There was significantlydifference in the different BNP groups and the normal control group.5Spearman correlations with BNP and the indices of oxidative stress andclinical indicatorsThe BNP serum levels in peritoneal dialysis patients were positivelycorrelated with MDA(r=0.368, P<0.01), AOPP(r=0.455, P<0.01), BUN(r=0.289, P<0.01), scr(r=0.249, P<0.05), age(r=0.298, P<0.01). There was asignificant negative correlation of BNP serum levels with Ca(r=-0.012,P<0.05), ALB(r=-0.443, P<0.01).Conclusions:1The serum BNP levels were increased in the continuous ambulatoryperitoneal dialysis patients, indating that the blood volume overload statewas increased in PD patients2There was a trend of an increase in the levels of serum levels BNPwith decreasing RRF in the continuous ambulatory peritoneal dialysispatients.3Oxidative stress was found in the continuous ambulatory peritonealdialysis patiens. There was an increase of oxidation products and a reduce ofantioxidant qualitative in the continuous ambulatory peritoneal dialysis patients.4The BNP serum levels were positively correlated with the oxidativestress state in continuous ambulatory peritoneal dialysis patients.