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Predictive role of BNP and NT-proBNP in hemodialysis patients

Linlin Sun1, Yan Sun, Xuezhi Zhao

  • 1Division of Nephrology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China. pierre_delanaye@yahoo.fr

Nephron. Clinical Practice
|October 30, 2008
PubMed

Insights

Brain natriuretic peptide (BNP) and NT-proBNP levels predict cardiovascular events in end-stage renal disease (ESRD) patients undergoing dialysis. NT-proBNP demonstrated superior predictive value for mortality compared to BNP.

Area of Science:

  • Nephrology
  • Cardiology
  • Biomarkers

Background:

  • Cardiovascular events (CVE) are a leading cause of death in end-stage renal disease (ESRD) patients.
  • Prognostic factors for CVE in ESRD patients, particularly those on hemodialysis, require further investigation.
  • Patients with ESRD are often excluded from cardiovascular clinical trials.

Purpose of the Study:

  • To investigate the prognostic value of B-type natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in predicting cardiovascular outcomes in hemodialysis patients with ESRD.
  • To assess the predictive accuracy of BNP and NT-proBNP for cardiovascular mortality, heart failure, and myocardial infarction in this population.

Main Methods:

  • Prospective study of 217 ESRD patients on hemodialysis.
  • Baseline assessment of BNP, NT-proBNP, dialysis adequacy indices, and biochemical markers.
  • Follow-up for 2 years to record cardiovascular events (CVE), including cardiovascular death, myocardial infarction, heart failure, and stroke.

Main Results:

  • Both BNP and NT-proBNP were significant predictors of cardiovascular mortality and fatal/nonfatal congestive heart failure (CHF).
  • NT-proBNP showed a stronger association with fatal/nonfatal myocardial infarction (MI) compared to BNP.
  • NT-proBNP exhibited a significantly better predictive value for mortality than BNP, as indicated by the area under the ROC curve (0.83 vs. 0.61).

Conclusions:

  • BNP and NT-proBNP are highly sensitive and specific biomarkers for predicting cardiovascular events in dialysis patients with ESRD.
  • NT-proBNP offers superior prognostic capability for mortality in this patient cohort compared to BNP.
Abstract

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