Determinants of N-Terminal Pro-Brain Natriuretic Peptide Variation in Hemodialysis Patients and Prediction of Survival

被引：7
作者：
Snaedal, Sunna [1 ,4 ]
Qureshi, Abdul R. [2 ]
Carrero, Juan J. [3 ]
Heimburger, Olof [1 ]
Stenvinkel, Peter [1 ]
Barany, Peter [1 ]
机构：
[1] Karolinska Inst, Dept Clin Sci Intervent & Technol, Div Renal Med, Stockholm, Sweden
[2] Karolinska Inst, Dept Baxter Novum, Stockholm, Sweden
[3] Karolinska Inst, Ctr Mol Med, Stockholm, Sweden
[4] Natl Univ Hosp Iceland, Landspitali, Div Nephrol, Reykjavik, Iceland
来源：
BLOOD PURIFICATION | 2014年 / 37卷 / 02期
基金：
英国医学研究理事会;
关键词：
N-Terminal pro-brain natriuretic peptide; Variability; Hemodialysis; Inflammation; Mortality; Nutritional status; STAGE RENAL-DISEASE; PERITONEAL-DIALYSIS PATIENTS; LEFT-VENTRICULAR DYSFUNCTION; CARDIAC TROPONIN-T; C-REACTIVE PROTEIN; HEART-FAILURE; SERUM-ALBUMIN; NUTRITIONAL-STATUS; FLUID OVERLOAD; KIDNEY-DISEASE;
D O I：
10.1159/000360267
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
Background/Aims: N-Terminal pro-brain natriuretic peptide (NT-proBNP) is a predictor of cardiac events and death in the general population and in chronic kidney disease. There is limited information on how natriuretic peptides vary in dialysis patients. The aim of this study was to analyze NT-proBNP variability, factors predicting its variability and survival related to NT-proBNP variability. Methods: A prospective 3-month observational study of prevalent hemodialysis patients with monthly measurements of NT-proBNP was carried out. A total of 211 hemodialysis patients were included, and mortality was recorded during 52 months of follow-up. Results: Inflammation was the strongest predictor of NT-proBNP variability. Patients with constantly high NT-proBNP had an increased risk of death adjusting for age, sex, dialysis vintage and comorbidity but not when also adjusting for nutritional status. Conclusions: Longitudinal changes in NT-proBNP are associated with changes in inflammation, nutritional status, age and comorbidity. Due to strong interactions with predictors of mortality such as nutritional status, we were unable to confirm NT-proBNP as an independent marker for mortality in dialysis patients. (C) 2014 S. Karger AG, Basel
引用
收藏
页码：138 / 145
页数：8
相关论文
共 46 条
[1]   Multi-biomarker risk stratification of N-terminal pro-B-type natriuretic peptide, high-sensitivity C-reactive protein, and cardiac troponin T and I in end-stage renal disease for all-cause death [J].
Apple, FS ;
Murakami, MM ;
Pearce, LA ;
Herzog, CA .
CLINICAL CHEMISTRY, 2004, 50 (12) :2279-2285
[2]   Physiological, pathological, pharmacological, biochemical and hematological factors affecting BNP and NT-proBNP [J].
Balion, Cynthia M. ;
Santaguida, Pasqualina ;
McKelvie, Robert ;
Hill, Stephen A. ;
McQueen, Matthew J. ;
Worster, Andrew ;
Raina, Parminder S. .
CLINICAL BIOCHEMISTRY, 2008, 41 (4-5) :231-239
[3]   Understanding amino-terminal pro-B-type natriuretic peptide in obesity [J].
Bayes-Genis, Antoni ;
DeFilippi, Christopher ;
Januzzi, James L., Jr. .
AMERICAN JOURNAL OF CARDIOLOGY, 2008, 101 (3A) :89A-94A
[4]   N-terminal proBNP-Marker of Cardiac Dysfunction, Fluid Overload, or Malnutrition in Hemodialysis Patients? [J].
Booth, John ;
Pinney, Jennifer ;
Davenport, Andrew .
CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2010, 5 (06) :1036-1040
[5]   Cardiac diseases in maintenance hemodialysis patients: Results of the HEMO Study [J].
Cheung, AK ;
Sarnak, MJ ;
Yan, GF ;
Berkoben, M ;
Heyka, R ;
Kaufman, A ;
Lewis, J ;
Rocco, M ;
Toto, R ;
Windus, D ;
Ornt, D ;
Levey, AS .
KIDNEY INTERNATIONAL, 2004, 65 (06) :2380-2389
[6]   Natriureettic peptides [J].
Daniels, Lori B. ;
Maisel, Alan S. .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2007, 50 (25) :2357-2368
[7]   Impact of body mass and body composition on circulating levels of natriuretic peptides - Results from the Dallas heart study [J].
Das, SR ;
Drazner, MH ;
Dries, DL ;
Vega, GL ;
Stanek, HG ;
Abdullah, SM ;
Canham, RM ;
Chung, AK ;
Leonard, D ;
Wians, FH ;
de Lemos, JA .
CIRCULATION, 2005, 112 (14) :2163-2168
[8]   Diagnostic value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) for left ventricular dysfunction in patients with chronic kidney disease stage 5 on haemodialysis [J].
David, Sascha ;
Kuempers, Philipp ;
Seidler, Vega ;
Biertz, Frank ;
Haller, Hermann ;
Fliser, Danilo .
NEPHROLOGY DIALYSIS TRANSPLANTATION, 2008, 23 (04) :1370-1377
[9]   Quantifying comorbidity in peritoneal dialysis patients and its relationship to other predictors of survival [J].
Davies, SJ ;
Phillips, L ;
Naish, PF ;
Russell, GI .
NEPHROLOGY DIALYSIS TRANSPLANTATION, 2002, 17 (06) :1085-1092
[10]   Association Between Serum Albumin and Mortality in Dialysis Patients Is Partly Explained by Inflammation, and Not by Malnutrition [J].
de Mutsert, Renee ;
Grootendorst, Diana C. ;
Indemans, Fleur ;
Boeschoten, Elisabeth W. ;
Krediet, Raymond T. ;
Dekker, Friedo W. .
JOURNAL OF RENAL NUTRITION, 2009, 19 (02) :127-135
12345