Article ; Online: N-terminal pro brain natriuretic peptide predicts both all-cause and cardiovascular disease mortality in Japanese hemodialysis patients.
Clinical and experimental nephrology
2021 Volume 25, Issue 10, Page(s) 1142–1150
Abstract: Background: The association between N-terminal pro brain natriuretic peptide (NT-proBNP) level and long-term mortality in Japanese hemodialysis patients has not been fully assessed.: Methods: This prospective, multicenter study included 1428 ... ...
| Abstract | Background: The association between N-terminal pro brain natriuretic peptide (NT-proBNP) level and long-term mortality in Japanese hemodialysis patients has not been fully assessed. Methods: This prospective, multicenter study included 1428 hemodialysis outpatients. Baseline NT-proBNP levels were measured at the first hemodialysis session of the week and participants were followed for 5 years. The areas under the curve were calculated from receiver operating characteristic curves. Groups determined by quartiles of baseline NT-proBNP level were assessed by the Kaplan-Meier method and log-rank test. The association between NT-proBNP level and mortality was assessed using multivariate Cox proportional hazards models. Results: During the 5-year follow-up, we observed 370 deaths and 256 censored cases. The areas under the curve of pre-hemodialysis NT-proBNP for all-cause mortality and cardiovascular disease mortality after 1 year were 0.75 and 0.78, respectively, and significantly greater than the areas under the curve at the 3- and 5-year follow-up. Cut-off values for all-cause mortality and cardiovascular disease mortality after 1 year were 4550 and 5467 ng/L, respectively (sensitivity: 82% and 81%; specificity: 59% and 64%). Kaplan-Meier survival analysis showed that the group with pre-hemodialysis NT-proBNP ≥ 8805 ng/L had increased all-cause mortality (P < 0.001) and cardiovascular disease mortality (P < 0.001). Finally, multivariate Cox analysis showed that NT-proBNP level was associated with all-cause mortality (P < 0.001) and cardiovascular disease mortality (P = 0.004) independently from other clinical parameters. Conclusion: NT-proBNP is a useful marker to predict both all-cause and cardiovascular disease mortality in hemodialysis patients. |
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| MeSH term(s) | Aged ; Aged, 80 and over ; Area Under Curve ; Biomarkers/blood ; Cardiovascular Diseases/mortality ; Cause of Death ; Female ; Follow-Up Studies ; Humans ; Japan/epidemiology ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Natriuretic Peptide, Brain/blood ; Peptide Fragments/blood ; Proportional Hazards Models ; Prospective Studies ; ROC Curve ; Renal Dialysis ; Renal Insufficiency/blood ; Renal Insufficiency/mortality ; Renal Insufficiency/therapy |
| Chemical Substances | Biomarkers ; Peptide Fragments ; pro-brain natriuretic peptide (1-76) ; Natriuretic Peptide, Brain (114471-18-0) |
| Language | English |
| Publishing date | 2021-06-09 |
| Publishing country | Japan |
| Document type | Journal Article ; Multicenter Study ; Observational Study |
| ZDB-ID | 1338768-6 |
| ISSN | 1437-7799 ; 1342-1751 |
| ISSN (online) | 1437-7799 |
| ISSN | 1342-1751 |
| DOI | 10.1007/s10157-021-02073-0 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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