| Introduction and Aims: To investigate the relationship between the serum fibroblast growth factor21(FGF-21)and N-terminal pro-brain natriuretic peptide(NT-proBNP)levels and the heart failure in the maintenance peritoneal dialysis combined with diabetes nephropathy(DN)patients by detecting the expression of serum FGF-21,NT-proBNP and other laboratory indicators and statistical analysising the basic clinical data,echocardiography in DN and non-DN peritoneal dialysis patients.Methods: We choose 348 maintenance peritoneal dialysis patients from January 2013 to October 2018 in our hospital group.The patients can be divided into DN group(178 cases)and non-DN group(170 cases).Firstly we compared the general clinical data,peritoneal dialysis index,echocardiographic parameters in two groups of this retrospective cohort study.Secondly we detected the serum level of FGF-21 and NT-proBNP,analysis the correlation of the clinical pathological physiological characteristics.Thirdly we drew the receiver-operating characteristic curve(receiver operating characteristic,ROC)to analysis the value of FGF-21 and NTproBNP in diagnostic the maintenance peritoneal dialysis combined with DN.Finally we initial assessed the value of FGF-21 and NTproBNP in the risk assessment of heart failure in diabetic peritoneal dialysis by Logistic regression analysis.Results:1.The hospitalized patients with heart failure in DN group was 64 cases(35.9%),which is more than 26 cases(15.2%)in non-DN group(P<0.05)during the follow up period(12.1±12.6 months).According to the attack of heart failure,the cases could be divided into heart failure group(HR group)and control group.The levels of white blood cell(WBC),left ventricular ejection fraction(LVEF)and triglyceride(TG)were higher in HR group than control group.2.The level of FGF-21 in the DN group(172.56 ±49.05pg/ml)was higher expression than that in the non-DN group(128.02 ±29.29pg/ml).The level of NT-proBNP in the DN group(16694±9842pg/ml)was higher expression than that in the non-DN group(8672±10196pg/ml),P<0.01.3.In ROC we could see a under curve(AUC)of FGF21 was 0.932,sensitivity / specificity was 93.1%/83.3 % and AUC of NT-proBNP was 0.973,sensitivity / specificity was 100 %/73.8 %.P=0.001.4.Multinomial Logistic regression analysis showed that FGF-21 and NTproBNP was an independent risk factor for heart failure in diabetic peritoneal dialysis(P < 0.05).Conclusions:The serum FGF-21 and NT-proBNP were higher expression in the peritoneal dialysis combined with diabetic nephropathy.They are the independent risk factors for heart failure in diabetic peritoneal dialysis and of great value in diagnosis and prognosis the heart failure.FGF21 could become a new predictor by Elisa in the future. |
