Can High BNP Levels Predict The Necessity of Emergency Hemodialysis in Patients With Acute Renal Failure

Abstract

There is not any known biomarker to suggest the necessity of hemodialysis in patients with acute renal failure. We studied if plasma brain natriuretic peptid levels are useful to suggest the necessity of hemodialysis in patients who are diagnosed acute renal failure with plasma creatinin level equal or greater than 2.5 mg/dl.
Method
The study was designed as a prospective study in a tertiary emergency department. Patients older than 14 years old who had plasma creatinin level equal or greater than 2.5 mg/dl and had not have hemodialysis regularly were involved in the study consecutively. The necessity of hemodialysis were decided by nephrologist.
Results
124 patients were involved in the study, 46 of them were evaluated as they had indication of hemodialysis. We found that the mean value of BNP for patients who had hemodialysis was 646.6±731.9 pg/ml and did not have hemodialysis was 446.2±723.9 pg/ml (p=0.141). We found that the mean values of BNP, 1040.1±1123.1 pg/ml for patients who had hemodialysis and 207.8±203.6 pg/ml for patients who did not have hemodialysis in total 19 patients with acute renal failure on chronic renal failure (p=0.04). We found that the mean value of BNP for 102 patients without heart failure history who had hemodialysis was 570.5±594.5 pg/ml and did not have hemodialysis was found 280.8±471.4 pg/ml (p<0.001).
Conclusion
We found that brain natriuretic peptid is not an objective criteria to determine the necessity of hemodialysis in patients who have acute renal failure with creatinin level equal or greater than 2.5 mg/dl.