Soluble Neprilysin, NT-proBNP, and Growth-Differentiation-Factor-15 as Biomarkers for Heart Failure in Dialysis Patients
Soluble Neprilysin, NT-proBNP, and Growth-Differentiation-Factor-15 as Biomarkers for Heart Failure in Dialysis Patients
Objectives: The aim of this study is to determine whether growth differentiation factor-15
 (GDF15) and circulating neprilysin (cNEP) improve the diagnosis of congestive heart failure
 (HF) in patients on dialysis.

 Background: Dialysis patients are at increased risk of HF. However, diagnostic utility of
 NT-proBNP as a biomarker is decreased in patients on dialysis. GDF15 and cNEP are biomarkers
 of distinct mechanisms that may contribute to HF pathophysiology in such cohorts.

 Methods: We compare circulating concentrations of NT-proBNP, GDF15, and cNEP along with NEP
 activity in patients on chronic dialysis without and with HF, as diagnosed by clinical
 parameters and post-dialysis echocardiography. We use correlation, linear and logistic
 regression as well as receiver operating characteristic (ROC) analyses.
Inclusion Criteria:

 -  ESRD on either chronic hemodialysis (HD) or peritoneal dialysis (PD) for ≥3 months

 Exclusion Criteria:

 -  previous switch of the type of renal replacement therapy from HD to PD or vice versa

 -  age <18 years

 -  pregnancy

 -  plasma exchange or apheresis in the past 6 months

 -  unipolar pacemaker

 -  history of whole extremity amputation