Research Article

The role of brain natriuretic peptide in the monitoring of ascites and treatment in chronic liver disease

Volume: 42 Number: 3 October 27, 2020
EN

The role of brain natriuretic peptide in the monitoring of ascites and treatment in chronic liver disease

Abstract

Objective: The aim of the study was to show the possible relationship between ascites formation and plasma Brain Natriuretic Peptide (BNP) levels, and to determine the importance of that relation for diagnosis and treatment in cirrhosis patients . 
Method: Forty-seven cirrhosis patients who had been followed in Akdeniz University Gastroenterology outpatient clinic were enrolled in the study. The proBNP levels and ultrasonographic (USG) ascites levels of the patients had been recorded together with the initial laboratory findings. After a 3-month period, proBNP and ascites levels had been determined in routine controls. Corresponding baseline and control results were evaluated.
Results: Plasma proBNP levels were significantly increased in patients with ascites at baseline and control. The baseline group had a proBNP level of 137.04 ± 69 pg / ml (p <0.05), and the control group 160.78 ± 76 pg / ml (p <0.05). Patients in the baseline cirrhosis group with ascites and control cirrhosis patients with increased and unchanged ascites level showed a significant increase in plasma proBNP levels with 140 ± 59.3 pg/ml at baseline and 206.01 ± 61.91 pg/ml after 3 months (p <0.05). Plasma pro BNP level was observed to decrease in patients with decreased ascites level, however. In the group with increased ascites level, proBNP level was 140.2 ± 51pg / ml at the baseline, and 206.1 ± 58 pg / ml after 3 months (p <0.05). ProBNP was identified to be decreased in the ascites group, however, the change was not statistically significant.
Conclusions: proBNP levels are significantly higher in patients with initial cirrhosis. There is a significant relationship between the amount of ascites fluid and plasma proBNP levels in cirrhosis patients.Although a numerical decrease in the group with decreased ascites was identified, the change was not statistically significant

Keywords

References

  1. Referans1. De Lemos JA, Mc Guire DK, Drazner MH. B-type natriuretic peptide in cardiovascular disease. Lancet. 2003; 362: 316-22. doi: 10.1016/S0140-6736(03)13976-1
  2. Referans2. Moller S, Bendtsen F, Henriksen JH. Effect of volume expansion on systemic hemodynamics and central and arterial blood volume in cirrhosis. Gastroenterology 1995; 109:1917-25
  3. Referans3. Yu CM, Sanderson JE. Plasmabrainnatriureticpeptide- an independentpredictor of cardiovascularmortality in acuteheartfailure. Eur J Heart Fail 1999;1:59-65.
  4. Referans4. Groszmann RJ. Vasodilatation and hyperdynamic circulatory state in chronic liver disease. In: Bosch J, Groszmann RJ, editors. Portal hypertension. Pathophysiology and treatment. Oxford: Blackwell 1994: 17-26.
  5. Referans5. Pimenta, J, Paulo C, Gomes A, Silva S, Rocha-Gonçalves F, Bettencourt P. B-type natriuretic peptide is related to cardiac function and prognosis in hospitalized patients with decompnesated cirrhosis. Liver International. 2010; 30: 1059–66. doi:10.1111/j.1478-3231.2010.02266.x, PMID: 20492497.
  6. Referans6. Kowalski HJ, Abelman WH. The cardiac output at rest in Laennecs Cirrhosis. J Clin Invest 1953; 32:1025-33.
  7. Referans7. Møller S, Henriksen JH. Circulatoryabnormalities in cirrhosiswithfocus on neurohumoralaspects. Semin Nephrol 1997;17:505-19.
  8. Referans8. McCullough PA, Omland T, Maisel AS. Btypenatriureticpeptides: A diagnosticbreakthroughforclinicians. RevCardiovascMed 2003;4:72-80.

Details

Primary Language

English

Subjects

Health Care Administration

Journal Section

Research Article

Publication Date

October 27, 2020

Submission Date

September 28, 2020

Acceptance Date

October 26, 2020

Published in Issue

Year 2020 Volume: 42 Number: 3

AMA
1.Çakın Ö, Yıldırım B. The role of brain natriuretic peptide in the monitoring of ascites and treatment in chronic liver disease. CMJ. 2020;42(3):338-343. doi:10.7197/cmj.vi.801340