N-terminal pro brain natriuretic peptide in hepatitis c virus maintenance hemodialysis patients and its relation to diastolic dysfunction and child pugh score

Background

Chronic kidney disease and end-stage renal disease (ESRD) are worldwide public health problems with increasing incidence and prevalence. Cardiovascular disease is the most common cause of morbidity and mortality among patients with ESRD. Hepatitis C virus (HCV) is a worldwide health problem. The prevalence of HCV infection among hemodialysis (HD) patients is generally much higher than that among the general population.

This study aimed to compare serum levels of N-terminal probrain natriuretic peptide (NT-ProBNP) and its relation to diastolic dysfunction and Child–Pugh in HCV-positive and HCV-negative patients on HD.

Patients and methods

This cross-sectional study included 60 ESRD patients; group A, 30 HCV-positive patients on HD, and group B, 30 HCV-negative patients on HD. Routine laboratory investigations, serum NT-ProBNP, and echocardiography were done for all patients.

Results

HCV-positive patients had a substantially higher median serum level of NT-ProBNP (3424.5 vs. 2807 pg/ml; P=0.031, respectively) than HCV-negative patients. The level of NT-ProBNP and diastolic dysfunction showed a strong positive correlation (P<0.001). The level of NT-ProBNP and the HCV RNA PCR level showed a significant positive correlation (P<0.001), and the level of NT-ProBNP increased significantly as the Child–Pugh score increased (P<0.001).

Conclusion

Compared to HCV-negative patients, HCV-positive dialysis patients exhibited more diastolic dysfunction and higher levels of NT-ProBNP. Additionally, HCV patients with Child–Pugh C had higher levels of NT-ProBNP than Child B and A patients, respectively.