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Are Brain Natriuretic Peptide Levels Related to Flow through Autologous Aterio-Venous Fistulae for Chronic Haemodialysis?

Original articles


Formation of arterio-venous-fistulae (AVF) may exacerbate cardiac failure in the ever increasing, elderly population on haemodialysis. Brain Natriuretic Peptide (BNP) may prove a useful marker of cardiac failure in this population. We  aimed  to  determine  effect  of  creation  of  an  AVF  and  flow  in AVF  on  BNP  levels.  Ten  patients  undergoing primary formation of an upper limb autologous AVF (pre-dialysis), were recruited. Serum BNP (pg/ml) and flow in AVF  (cm3/s)  were  documented  pre-operatively,  and  then  2,  6  and  12  weeks  post-operatively.  The  relationship between flow and BNP levels was assessed. Ten patients (6 male), mean age of 66yrs were recruited. Five patients had a radio-cephalic and 5 had a brachio-cephalic AVF formed. There was no correlation between BNP levels and flow within the AVF (r=0.34, p=0.28) at any time point. There  was a  general  trend towards increased  flow in the AVF over time, with only the change between flow at 2-weeks and 3-months postoperatively reaching significance, p=0.043. There was a general trend for BNP to fall over time in the postoperative period, with no significant change between the postoperative sampling time points. BNP levels do not correlate with flow across an AVF.