Sažetak
Uvod/Cilj. Bolesnici sa hroničnom bubrežnom insuficijencijom (HBI) imaju povećan kardiovaskularni morbiditet i mortalitet. Nije poznato koji biomarkeri najbolje opisuju stepen dijastolne disfunkcije kod bolesnika sa HBI. Cilj ove studije bio je da se utvrdi povezanost koncentracije B-tipa natriuretskog peptida (BNP), N-terminalnog prohormon moždanog natriuretskog peptida (NTproBNP) i dijastolne disfunkcije leve komore (DD-LV) sa stepenom HBI. Metode. U studiju je bilo uključeno 100 odraslih bolesnika sa hroničnom bubrežnom bolesti koji nisu imali srčane i cerebralne incidente i nisu započeli aktivno lečenje HBI. Prema stepenu HBI bolesnike smo podelili u dve grupe: G1 (umereni stepen), glomerularna filtracija (GFR) ≥ 30 mL/min/1,73 m2, i G2 (teži stepen), GFR < 30 mL/min/1,73 m2. U krvi su određene koncentracije BNP i NTproBNP, a dopler ehokardiografskim merenjem procenjena je dijastolna disfunkcija leve komore (DD-LV). Prema stepenu DD-LV bolesnici su podeljeni u dve grupe: DD-LV1 (blaga dijastolna disfunkcija) i DD-LV2 (teška dijastolna disfunkcija). Prema stepenu HBI i DD-LV bolesnici su podeljeni u četiri grupe: I (G1, DD-LV1), II (G1, DD-LV2), III (G2, DD-LV1) i IV (G2, DD-LV2). Rezultati. Utvrđena je visokoznačajna statistička korelacija BNP i NTproBNP sa GFR (p < 0,001), a DD-LV sa BNP (p < 0,023), odnosno NTproBNP (p = 0,035). Registrovane su statistički značajno više koncentracije BNP kod bolesnika sa DD LV2, nego kod bolesnika sa G2 (p < 0,001). Za razliku od BNP, kod bolesnika sa disfunkcijom DD-LV1, ali i onih sa disfunkcijom DD-LV2, registrovane su statistički značajno veće koncentracije NTproBNP kod bolesnika sa G2 (DD-LV1: p = 0,006; DD-LV2: p < 0,001). Zaključak. Biomarkeri BNP i NTproBNP nisu najbolji prediktori u proceni dijastolne disfunkcije jer su u korelaciji sa stepenom hronične bubrežne insuficijencije.
Ključne reči
chronic||
||bubreg
hronična insuficijencija
glomerular filtration rate||
||glomerulska filtracija
ventricular function
left||
||srce
funkcija leve komore
natriuretic peptides||
||natriuretski peptidi
biological markers||
||biološki pokazatelji
sensitivity and specificity||
||senzitivnost i specifičnost
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