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What is the role of cardiac biomarkers (BNP, NT-proBNP, and troponin) as prognostic indicators and tools for volume assessment in peritoneal dialysis patients?
What is the role of cardiac biomarkers (BNP, NT-proBNP, and troponin) as prognostic indicators and tools for volume assessment in peritoneal dialysis patients?
This review examines the utility of cardiac biomarkers for volume assessment and cardiovascular prognostication in peritoneal dialysis patients.
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May support biomarker-guided volume assessment in peritoneal dialysis; leaves open prospective validation for prognostication.
Cardiac biomarkers such as brain natriuretic peptide, amino-terminal pro-B-type natriuretic peptide (NT-proBNP), and cardiac troponin provide information on cardiovascular morbidity and mortality in patients with normal renal function. In a considerable number of chronic hemodialysis patients, both biomarkers-NT-proBNP and troponin-are elevated despite the absence of cardiac ischemia. The elevation of cardiac biomarkers in chronic hemodialysis patients is of prognostic value with respect to cardiovascular morbidity and mortality. Furthermore, they can serve as tools for volume assessment for optimization of the fluid management aspect of dialysis. However, the association of both these markers in peritoneal dialysis is not clear. Therefore, the authors reviewed the literature to examine the role of these markers in peritoneal dialysis patients both as prognostic indicators as well as tools for volume assessment.
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Garg et al. (2009) studied this question.
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