유지 혈액투석 환자에서 단기간의 빈혈 개선에 따른 혈중 Amino-Terminal Pro B-type NatriureticPeptide (NT-pro BNP)치 및 심초음파 소견의 변화

Abstract

Background: Anemia is known to be one of the important risk factors in the development and the aggravation of cardiovascular diseases. This study was undertaken to evaluate the effect of anemia correction on blood NT-pro BNP level and echocardiographic parameters in ESRD patients on hemodialysis. Methods: Recombinant human erythropoietin (rHuEPO) was administered in 20 hemodialysis patients (median age 51.5, M : F=2.3:1) with a target hemoglobin>12.0 g/dL for 3 months. All patients were subjected to a serial follow-up of hemoglobin, hematocrit, and NT-pro BNP. Echocardiographic examination was also performed before and after 3 months of therapy. Results: Hemoglobin was increased at 3 months [12.3 g/dL (11.8-13.6)] compared with baseline [9.8 g/dL (9.1-10.4)] (p<0.01), and NT-pro BNP was significantly decreased at 3 months [3415 pg/mL (2717-8160)] compared with baseline [6371 pg/mL (2338-18269)] (p<0.05). Echocardiographic examination revealed no significant changes in left ventricular ejection fraction and left ventricular mass index. In Doppler imaging, however, there was significant decrease in E velocity [62.5 ㎝/sec (52.8-83.5) vs. 57.0 ㎝/sec (45.0-60.0), p<0.05], thereby decrement in E/E′ [15.6 (13.4-25.7) vs. 14.3 (11.5-22.2), p<0.05]. Conclusion: Partial correction of anemia with rHuEPO in ESRD patients on hemodialysis results in the reduction of blood NT-pro BNP level and the decrease of E velocity and E/E′.