B-Type Natriuretic Peptide in End-Stage Renal Disease: A Neurohormone Rather Than a Volume Status Monitor

Authors: Micha T. Maeder, MD, David M. Kaye, MD, PhD


A biomarker assisting in estimating volume status in patients with end-stage renal disease (ESRD) would be very helpful in clinical practice. In this issue of the Southern Medical Journal, Flemmer et al1 evaluated whether changes in B-type natriuretic peptide (BNP), a relatively cardiac-specific 32-amino acid polypeptide released following increased cardiomyocyte stretch and other stimuli, reflect fluid removal during hemodialysis (HD). BNP was measured before and after HD on five occasions in 151 ESRD patients. Although body weight and blood pressure were reduced by HD, there was no change in BNP.

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