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Chen C, Hsu YC, Chou KW, Chang KS, Hsu YH, Chiu WH, Lee CW, Yang PS, Chang WH, Huang YK, Chen PY, Chen CW, Su YJ. NT-proBNP point-of-care testing for predicting mortality in end-stage renal disease: A survival analysis. Heliyon 2024; 10:e30581. [PMID: 38742053 PMCID: PMC11089362 DOI: 10.1016/j.heliyon.2024.e30581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 04/29/2024] [Accepted: 04/29/2024] [Indexed: 05/16/2024] Open
Abstract
This study examines the predictive value of elevated N-terminal-pro brain natriuretic peptide (NT-pro BNP) levels for mortality among patients with end-stage renal disease (ESRD). Data from 768 ESRD patients, excluding those with cancer or lost follow-up, were analyzed using Kaplan-Meier curves and Cox proportional hazards models over three years. Results indicated that patients with very high NT-pro BNP levels had shorter average survival times and a significantly higher risk of mortality (hazard ratio 1.43). Advanced age, ICU admission, and comorbidities like cerebrovascular diseases and chronic obstructive pulmonary disease also contributed to increased mortality risks. Thus, elevated NT-pro BNP is an independent risk factor for mortality in ESRD patients.
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Affiliation(s)
- Chun Chen
- Department of Emergency Medicine, Mackay Memorial Hospital, Taipei, Taiwan
| | - Yin-Chen Hsu
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital Chiayi Branch, Chiayi, Taiwan
- Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - Kuang-Wei Chou
- Department of Emergency Medicine, Mackay Memorial Hospital, Taipei, Taiwan
- Department of Nursing, Yuanpei University of Medical Technology, Hsinchu, Taiwan
| | - Kuo-Song Chang
- Department of Emergency Medicine, Mackay Memorial Hospital, Taipei, Taiwan
- Mackay Junior College of Medicine Nursing and Management, Taipei, Taiwan
| | - Ya-Hui Hsu
- Department of Emergency Medicine, Mackay Memorial Hospital, Taipei, Taiwan
| | - Wei-Huai Chiu
- Graduate Institute of Automation and Control, National Taiwan University of Science and Technology, Taipei, Taiwan
| | - Chun-Wei Lee
- Mackay Junior College of Medicine Nursing and Management, Taipei, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei, Taiwan
- Cardiovascular Division, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Po-Sheng Yang
- Department of Medicine, MacKay Medical College, New Taipei, Taiwan
- Department of general surgery, MacKay Memorial Hospital, Taipei, Taiwan
| | - Wen-Han Chang
- Department of Emergency Medicine, Mackay Memorial Hospital, Taipei, Taiwan
- Department of Nursing, Yuanpei University of Medical Technology, Hsinchu, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei, Taiwan
- Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan
- Institute of Mechatronic Engineering, National Taipei University of Technology, Taipei, Taiwan
- School of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yao-Kuang Huang
- Chang Gung University, College of Medicine, Taoyuan, Taiwan
- Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital Chiayi Branch, Chiayi, Taiwan
- Division of Thoracic and Cardiovascular Surgery, Chia Yi Hospital, Ministry of Health and Welfare, Chiayi, Taiwan
| | - Pang-Yen Chen
- Department of Emergency Medicine, Mackay Memorial Hospital, Taipei, Taiwan
- Department of Nursing, Yuanpei University of Medical Technology, Hsinchu, Taiwan
- Mackay Junior College of Medicine Nursing and Management, Taipei, Taiwan
| | - Chien-Wei Chen
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital Chiayi Branch, Chiayi, Taiwan
- Chang Gung University, College of Medicine, Taoyuan, Taiwan
- Department of Nursing, Yuanpei University of Medical Technology, Hsinchu, Taiwan
| | - Yu-Jang Su
- Department of Emergency Medicine, Mackay Memorial Hospital, Taipei, Taiwan
- Department of Nursing, Yuanpei University of Medical Technology, Hsinchu, Taiwan
- Mackay Junior College of Medicine Nursing and Management, Taipei, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei, Taiwan
- Division of Toxicology, Mackay Memorial Hospital, Taipei, 10449, Taiwan
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Wang Y, Cao X, Yu J, Zhang Y, Li X, Chen X, Zou J, Shen B, Ding X. Association of N-Terminal Pro-brain Natriuretic Peptide With Volume Status and Cardiac Function in Hemodialysis Patients. Front Cardiovasc Med 2021; 8:646402. [PMID: 33693039 PMCID: PMC7937607 DOI: 10.3389/fcvm.2021.646402] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 02/01/2021] [Indexed: 12/16/2022] Open
Abstract
Introduction: N-terminal-pro-brain natriuretic peptide (NT-pro BNP) is secreted by cardiomyocytes in cases of cardiac structure disorder and volume overload. However, the relationship between NT-pro BNP level and body fluid status in dialysis patients with reduced cardiac ejection function (EF) is uncertain. Therefore, we aimed to investigate this relationship. Methods: We enrolled patients who had been receiving hemodialysis for >3 months. Blood sample, transthoracic echocardiographic, and bioimpedance spectroscopy measurements were performed during a midweek non-dialysis day. The predictive value of NT-pro BNP in hemodialysis patients with volume overload was analyzed. Results: A total of 129 hemodialysis patients (74 men and 55 women; mean age: 59.4 ± 13.0 years) were recruited. The average hemodialysis duration was 55.5 (23.9–93.4) months, the NT-pro BNP level was 4992 (2,033–15,807) pg/mL, and the value of overhydration was 2.68 ± 0.19 (−1.9 to 12.2) L. The NT-pro BNP level was independently correlated with overhydration in both the LVEF ≥ 60% (β = 0.236, P = 0.044) and LVEF <60% (β = 0.516, P = 0.032) groups, even after adjustments for potentially confounding variables. In receiver operating characteristic curves of NT-pro BNP for predicting volume overload, the area under the curve was 0.783 [95% CI (0.688–0.879), P < 0.001) and 0.788 [95% CI (0.586–0.989), P < 0.001] in the LVEF ≥ 60% and LVEF < 60% groups, respectively. Conclusions: NT-pro BNP is a predictive factor for volume overload in hemodialysis patients with or without EF declines.
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Affiliation(s)
- Yaqiong Wang
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Medical Center of Kidney, Shanghai, China.,Department of Nephrology, Shanghai Institute of Kidney and Dialysis, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.,Hemodialysis Quality Control Center of Shanghai, Shanghai, China
| | - Xuesen Cao
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Medical Center of Kidney, Shanghai, China.,Department of Nephrology, Shanghai Institute of Kidney and Dialysis, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.,Hemodialysis Quality Control Center of Shanghai, Shanghai, China
| | - Jinbo Yu
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Medical Center of Kidney, Shanghai, China.,Department of Nephrology, Shanghai Institute of Kidney and Dialysis, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.,Hemodialysis Quality Control Center of Shanghai, Shanghai, China
| | - Yongmei Zhang
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Medical Center of Kidney, Shanghai, China.,Department of Nephrology, Shanghai Institute of Kidney and Dialysis, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.,Hemodialysis Quality Control Center of Shanghai, Shanghai, China
| | - Xianzhe Li
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Medical Center of Kidney, Shanghai, China.,Department of Nephrology, Shanghai Institute of Kidney and Dialysis, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.,Hemodialysis Quality Control Center of Shanghai, Shanghai, China
| | - Xiaohong Chen
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Medical Center of Kidney, Shanghai, China.,Department of Nephrology, Shanghai Institute of Kidney and Dialysis, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.,Hemodialysis Quality Control Center of Shanghai, Shanghai, China
| | - Jianzhou Zou
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Medical Center of Kidney, Shanghai, China.,Department of Nephrology, Shanghai Institute of Kidney and Dialysis, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.,Hemodialysis Quality Control Center of Shanghai, Shanghai, China
| | - Bo Shen
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Medical Center of Kidney, Shanghai, China.,Department of Nephrology, Shanghai Institute of Kidney and Dialysis, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.,Hemodialysis Quality Control Center of Shanghai, Shanghai, China
| | - Xiaoqiang Ding
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Medical Center of Kidney, Shanghai, China.,Department of Nephrology, Shanghai Institute of Kidney and Dialysis, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.,Hemodialysis Quality Control Center of Shanghai, Shanghai, China
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