tailieunhanh - Summary of medical doctoral thesis: Changes in B type natriuretic peptide levels in patients with chronic renal failure on hemodialysis

Research mission: The characteristics and changes in plasma (natriuretic peptide type B) BNP levels in patients with chronic renal failure on hemodialysis. Understanding correlation between plasma BNP levels with some morphological parameters of ultrasound, left ventricular systolic function and value of BNP in predicting heart failure, mortality prognosis in patients with chronic renal failure undergoing dialysis. | In our study, the prognostic value of BNP in mortality are shown on the ROC curve (AUC= ; CI 95% [ ), p= ). Several other studies examined the prognostic value of BNP and mortality for the same results, the study of Selim noted AUC = ; 95% CI [ ], the study of Artunc AUC = ; 95% CI [ ]. BNP cutoff point in fatal prognosis differ between studies. We define the intersection of the BNP in fatal prognosis at 961 pg/ ml with sensitivity, specificity: , HR = . In the study of Artunc recorded lower cut points of BNP in our study, in contrast, study author Selim higher than our study. This problem may be related to the object of study: the percentage of patients with LVH and heart failure, type of membrane. Unlike previous studies, we did not observe differences in LVMI, EF, rate patients with LVH, percentage of patients with heart failure and left ventricular dysfunction between the two groups of fatal and non- fatal patients in univariate and multivariate analysis. This is probably because the average follow-up period in our study is relatively short compared with other studies. However, past research findings and our previous findings showed that BNP have prognostic value for mortality in HD patients in a short time (1 year) or long as the research results before. Kaplan Meier analysis to compare survival in HD patients recognized patient groups BNP levels> 961 pg /ml had a lower survival with statistical significance compared with the other group (p= ). Although the reason why higher BNP levels related to mortality in HD patients is unclear. The rise of the BNP is closely linked with the state of myocardial ischemia. Myocardial ischemia can be triggers cardiac arrhythmia condition and the expression reflecting the progression of atherosclerosis can be the basis for changes related to the pathophysiology of stroke.