Yonsei Med J.  2015 Jul;56(4):976-980. 10.3349/ymj.2015.56.4.976.

Copeptin in Hemodialysis Patients with Left Ventricular Dysfunction

• Kim JS
• Yang JW
• Chai MH
• Lee JY
• Park H
• Kim Y
• Choi SO
• Han BG

• KMID: 2366337
• DOI: http://doi.org/10.3349/ymj.2015.56.4.976

Abstract

PURPOSE
Copeptin has been considered as a useful marker for diagnosis and prediction of prognosis in heart diseases. However, copeptin has not been investigated sufficiently in hemodialysis patients. This study aimed to investigate the general features of copeptin in hemodialysis and to examine the usefulness of copeptin in hemodialysis patients with left ventricular dysfunction (LV dysfunction).
MATERIALS AND METHODS
This study included 41 patients on regular hemodialysis. Routine laboratory data and peptides such as the N-terminal of the prohormone brain natriuretic peptide and copeptin were measured on the day of hemodialysis. Body fluid volume was estimated by bioimpedance spectroscopy, and the E/Ea ratio was estimated by echocardiography.
RESULTS
Copeptin increased to 171.4 pg/mL before hemodialysis. The copeptin had a positive correlation with pre-dialysis body fluid volume (r=0.314; p=0.04). The copeptin level decreased along with body fluid volume and plasma osmolality during hemodialysis. The copeptin increased in the patients with LV dysfunction more than in those with normal LV function (218.7 pg/mL vs. 77.6 pg/mL; p=0.01). Receiver operating characteristic curve analysis showed that copeptin had a diagnostic value in the hemodialysis patients with LV dysfunction (area under curve 0.737; p=0.02) and that the cut-off value was 125.48 pg/mL (sensitivity 0.7, specificity 0.8, positive predictive value 0.9, negative predictive value 0.6).
CONCLUSION
Copeptin increases in hemodialysis patients and is higher in patients with LV dysfunction. We believe that copeptin can be a useful marker for the diagnosis of LV dysfunction in hemodialysis patients.

Keyword

Copeptin; hemodialysis; ventricular dysfunction

MeSH Terms

Adult
Aged
Biomarkers/blood
Echocardiography
Female
Glycopeptides/*blood
Humans
Kidney Failure, Chronic/*blood/complications/therapy
Male
Middle Aged
Natriuretic Peptide, Brain/blood
Predictive Value of Tests
Prognosis
ROC Curve
Renal Dialysis/*adverse effects
Sensitivity and Specificity
Ventricular Dysfunction, Left/*blood/complications/*physiopathology
Biomarkers
Glycopeptides
Natriuretic Peptide, Brain

Figure

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  Fig. 1 Correlation between pre-dialysis copeptin (pre-copeptin) and pre-dialysis overhydration (pre-OH). OH, overhydration.

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  Fig. 2 Comparison of pre-dialysis copeptin (pre-copeptin) levels between patients with normal LV function and those with LV dysfunction. LV, left ventricular-.

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