Relationship between renalase and N-terminal pro-B-type Natriuretic Peptide (NT pro-BNP) in haemodialysis patients
More details
Hide details
Department of Laboratory Diagnostic, Medical University of Lublin, Poland
Oral Medicine Independent Unit, Medical University of Lublin, Poland
Department of Nephrology, Medical University of Lublin, Poland
Institute of Rural Health, Lublin, Poland
Department of Public Health, Institute of Rural Health, Lublin, Poland
Marcin Dziedzic   

Department of Laboratory Diagnostic, Medical University of Lublin, Poland
Ann Agric Environ Med. 2014;21(1):132–135
Our knowledge in the field of cause of deaths in dialysis patients is rapidly expanding, yet we still do not fully understand how renalase regulates the processes of cardiovascular disease developing in end-stage renal disease. Increased sympathetic nerve activity observed in chronic kidney diseases due to raised catecholamines in plasma results from the absence of renalase. Renalase synthesized and secreted by the kidneys participate in the regulation of sympathetic tone and blood pressure. A family of natriuretic peptides has been identified – NT pro-BNP – which seems to be the best predictor of clinical outcome and marker of extracellular fluid overload, as well as predicting mortality, irrespective of renal function.

The aim of the presented study was to investigate renalase concentration and investigate associations between NT-proBNP, as well as analyzed parameters in haemodialysis patients.

Material and Methods:
The study was conducted among residents of the municipality and neighbouring villages in the province of Lublin, central-eastern Poland. 49 male subjects on haemodialysis, aged 65.3 ± 14.2 years, median time on haemodialysis: 37.5 months, were included. All study subjects underwent haemodialysis 3 times a week. The mean concentration of renalase in the entire study population was 126.59 ± 32.63 ng/mL. The circulating levels of NT-proBNP was 813.64 ± 706.96 pg/mL. A significant inverse correlation was found between NT-proBNP and renalase plasma levels (R = –0.3, P = 0.03).

Inverse correlation between NT-proBNP and renalase plasma levels in haemodialysis patients were due to impaired kidney function, accompanied by increased sympathetic nerve activity, which have an impact on the development of hypertension and cardiovascular complications.

Rutkowski B, et al. Report On The Renal Replacement Therapy In Poland – 2007 Gdańsk 2009. p.1–122 (access: 17.03. 2014).
Agarwal R, Nissenson AR, Batlle D, Coyne DW, Trout JR, Warnock DG. Prevalence, treatment, and control of hypertension in chronic hemodialysis patients in the United States. Am J Med. 2003; 115(4): 291–297.
Sarnak MJ, Levey AS. Epidemiology, diagnosis, and management of cardiac disease in chronic renal disease. J Thromb Thrombolysis. 2000; 10(2): 169–180.
Schärer K, Schmidt KG, Soergel M. Cardiac function and structure in patients with chronic renal failure. Pediatr Nephrol. 1999; 13(9): 951–965.
Xu J, Li G, Wang P, Velazquez H, Yao X, Li Y, et al. Renalase is a novel, soluble monoamine oxidase that regulates cardiac function and blood pressure. J Clin Invest. 2005;115(5): 1275–1280.
Li G, Xu J, Wang P, Velazquez H, Li Y, Wu Y, Desir GV. Catecholamines regulate the activity, secretion, and synthesis of renalase. Circulation. 2008; 117(10): 1277–1282.
Xu J, Desir GV. Renalase, a new renal hormone: its role in health and disease. Curr Opin Nephrol Hypertens. 2007; 16(4): 373–378.
Rinat C, Becker-Cohen R, Nir A, Feinstein S, et al. B-type natriuretic peptides are reliable markers of cardiac strain in CKD pediatric patients. Pediatr Nephrol. 2012; 27(4): 617–625.
Bettencourt P, Azevedo A, Pimenta J, Friões F, Ferreira S, Ferreira A. N-terminal-pro-brain natriuretic peptide predicts outcome after hospital discharge in heart failure patients. Circulation. 2004; 110(15): 2168–2174.
David S, Kümpers P, Seidler V, Biertz F, Haller H, Fliser D. Diagnostic value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) for left ventricular dysfunction in patients with chronic kidney disease stage 5 on haemodialysis. Nephrol Dial Transplant. 2008; 23(4): 1370–1377.
Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987; 40(5): 373–383.
Daugirdas JT. Second generation logarithmic estimates of single-pool variable volume Kt/V: an analysis of error. J Am Soc Nephrol. 1994; 4(5): 1205–1213.
Kopple JD; National Kidney Foundation K/DOQI Work Group. The National Kidney Foundation K/DOQI clinical practice guidelines for dietary protein intake for chronic dialysis patients. Am J Kidney Dis. 2001; 38: 68–73.
Xu J, Li G, Wang P, Velazquez H, Yao X, Li Y, et al. Renalase is a novel, soluble monoamine oxidase that regulates cardiac function and blood pressure. J Clin Invest. 2005; 115(5): 1275–1280.
Wu Y, Xu J, Velazquez H, Wang P, Li G, Liu D, Sampaio-Maia B, et al. Renalase deficiency aggravates ischemic myocardial damage. Kidney Int. 2011; 79(8): 853–860.
Zbroch E, Malyszko J, Malyszko JS, Koc-Zorawska E, Mysliwiec M. Renalase, a novel enzyme involved in blood pressure regulation, is related to kidney function but not to blood pressure in hemodialysis patients. Kidney Blood Press Res. 2012; 35(6): 395–399.
Austin WJ, Bhalla V, Hernandez-Arce I, Isakson SR, Beede J, et al. Correlation and prognostic utility of B-type natriuretic peptide and its amino-terminal fragment in patients with chronic kidney disease. Am J Clin Pathol. 2006;126(4): 506–512.
Spanaus KS, Kronenberg F, Ritz E, Schlapbach R, et al. B-type natriuretic peptide concentrations predict the progression of nondiabetic chronic kidney disease: the Mild-to-Moderate Kidney Disease Study. Clin Chem. 2007; 53(7): 1264–1272.
Tagore R, Ling LH, Yang H, et al. Natriuretic peptides in chronic kidney disease. Clin J Am Soc Nephrol. 2008; 3(6): 1644–1651.
Saha M, Faroque MO, Alam KS, Alam MM, Ahmed S. Chronic kidney disease specific cardiovascular risk factors among non dialytic patients with chronic kidney disease stage-V--an experience of a specialized hospital. Bangladesh Med Res Counc Bull. 2012; 38(1): 18–22.
Afshar R, Sanavi S, Salimi J, Ahmadzadeh M. Hematological profile of chronic kidney disease (CKD) patients in Iran, in pre-dialysis stages and after initiation of hemodialysis. Saudi J Kidney Dis Transpl. 2010; 21(2): 368–371.
Ijoma C, Ulasi I, Ijoma U, Ifebunandu N. High prevalence of anemia in predialysis patients in Enugu, Nigeria. Nephrology Reviews, 2010; 2e14: 61–65.
Effat A.E. Tony, Mohamed M.A. Ashmawy, Soheir M, et al. Prognostic Values of N-Terminal-Pro Brain Naturetic Peptide and Myocardial Perfusion Single Photon Emission as diagnostic tools for Asymptomatic Cardiac Events in Chronic kidney Disease. Journal of American Science 2012; 8(12): 1037–1056.
Vanzetto G, Jacon P, Calizzano A, Neuder Y, Faure P, Fagret D, Machecourt J. N-terminal pro-brain natriuretic peptide predicts myocardial ischemia and is related to postischemic left-ventricular dysfunction in patients with stable coronary artery disease. J Nucl Cardiol. 2007; 14(6): 835–842.
Tripepi G, Mattace Raso F, Sijbrands E, Seck MS, et al. Inflammation and asymmetric dimethylarginine for predicting death and cardiovascular events in ESRD patients. Clin J Am Soc Nephrol. 2011; 6(7): 1714–1721.