Objective To observe the effect of serum N-terminal pro-B type natriuretic peptide (NT-proBNP) combined with online blood volume monitor (BVM) in the assessment of volume overload and complications in patients with maintenance hemodialysis (MHD).
Methods A total of 140 MHD patients were selected as objectives, and percentage of interdialysis body weight gain (PIBWG) was used as a standard to evaluate volume overload. Plasma NT-proBNP levels were measured before dialysis and 2, 4 hours after dialysis. Online relative blood volume (RBV) was monitored by BVM system. Pearson correlation analysis was used to analyze the correlations between plasma NT-proBNP, RBV levels and PIBWG, left ventricular end diastolic volume (LVEDV). The incidence of dialysis complications such as hypotension and arrhythmia was observed.
Results The average PIBWG of 140 patients was (4.33±1.26)%. According to the value of PIBWG, the patients were divided into low volume group (PIBWG < 4.33%, n=50) and high volume group (PIBWG≥4.33%, n=90). The plasma levels of NT-proBNP and RBV at 2 and 4 h after dialysis in the high volume group were significantly higher than those in the low volume group, and the variation value was significantly smaller than that in the low volume group (P < 0.05). Pearson correlation analysis showed that PIBWG and LVEDV were respectively positively correlated with variation values of plasma NT-proBNP and RBV (P < 0.05 or P < 0.01). The incidence of dialysis complications in the high volume group was significantly lower than that in the low volume group (P < 0.05).
Conclusion Plasma NT-proBNP level combined with BVM can be used to evaluate the volume overload and incidence of complications in MHD patients, which is consistent with PIBWG and LVEDV levels. Analysis in variation values of plasma NT-proBNP or RBV levels between 2, 4 h after dialysis and before dialysis can provide more information for accurate evaluation of dialysis efficiency and safety.
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