Abstract:

【Abstract】 Objective To investigate the correlation of serum levels of brain natriuretic peptide (BNP), interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and c-reactive protein (CRP) to left ventricular remodeling in elderly patients treated with maintenance hemodialysis (MHD). Methods We recruited 64 elderly MHD patients who had treated with hemodialysis for at least 3 months before the study and were in a stable clinic status without signs of infection or other active diseases. Serum BNP was assayed by chemiluminescence, and serum IL-1β, IL-6 and TNF-α were measured by enzyme-linked immunosorbent assay. Left atrial diameter (LAD), left ventricular end diastolic diameter (LVDd), left ventricular end systolic diameter (LVDs), interventricular septal thickness (IVST), left ventricular posterior wall thickness (LVPWT) and left ventricular ejection fraction (LVEF) were evaluated by ultrasonic cardiography. Results In elderly MHD patients, the average serum BNP, IL-1β, IL-6, TNF-α and CRP were higher than those of normal control group (P<0.05 or <0.01), LAD, LVDd, IVST, LVPWT (P<0.05 or <0.01) and calculated left ventricular mass index (LVMI) (P＜0.01) increased, and LVEF decreased (P<0.05). In these patients, serum BNP level was positively correlated with the levels of LAD, LVDd, IVST, LVPWT and LVMI (P<0.05 or <0.01), and the serum levels of CRP, IL-1β, IL-6, TNF-α and lipoprotein (a) (P<0.05 or <0.01). Serum BNP level was negatively correlated with the level of LVEF (P<0.05) and also with serum levels of albumin, total cholesterol and high-density lipoprotein cholesterol (HDL-C) (P<0.05 or <0.01). Conclusion Higher serum BNP was frequently seen in elderly MHD patients, and this increase was closely related with left ventricle remodeling.

Key words: Interleukin, Tumor necrosis factor-α, Ventricular remodeling, Hemodialysis