The importance of BNP in differantial diagnosis and prognosis ofpatients with ascites related to and non-related to liver disease

Although the most common cause of ascites is liver cirrhosis in the world, it can be seen in patients with heart failure and malignancies. Sinusoidal hypertension is the main pathology in the formation of ascites in both heart failure and cirrhosis. Therefore, serum ascites albumin gradient in both cases is ≥ 1.1 g / dl. Serum type B natriuretic peptide (BNP) is a type of peptide used as a diagnostic marker in heart failure. At the same time, BNP levels may increase in patients with cirrhosis and can be associated with the severity of liver disease. The aim of this study is; to determine whether BNP can be used as a marker in the differential diagnosis of ascites etiology and also as a prognostic marker for cirrhosis. The study group consisted of 62 patients with cirrhosis and ascites, 66 patients with non-cirrhosis and ascites, and 42 patients with non- ascites cirrhosis. The patients underwent echocardiography at the same center, diagnostic paracentesis was performed and simultaneous venous blood samples were collected. Serum ascites - albumin gradients were calculated. BNP and complete blood count and biochemical values, complications and survival were evaluated. BNP values in patients with heart failure were found to be statistically significantly higher than others. In patients with cirrhosis BNP was inversely correlated with platelet count and serum albumin levels. BNP levels were positively correlated with hepatic encephalopathy, hepatorenal syndrome and spontaneous bacterial peritonitis. There were no significant relation between BNP, esophageal variceal degree and variceal bleeding. Patients with lower BNP levels lived longer, but this was not statistically significant. In conclusion, we think that BNP can be used as a marker in differential diagnosis of ascites and can predict the development of HES, HRS, SBP complications in cirrhosis. Keywords: Ascites, BNP, liver cirrhosis, heart failure, portal hypertension.