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B-type natriuretic peptide and severe heart failure at baseline predict overall mortality in incident dialysis

M Koch1, R Trapp, M Kohnle

  • 1Center of Nephrology, Mettmann, Heinrich Heine University Düsseldorf, Germany. dialyse-mettmann.de

Clinical Nephrology
|December 31, 2009
PubMed

Insights

Higher baseline B-type natriuretic peptide (BNP) levels predict death in incident hemodialysis patients. However, severe heart failure is a stronger predictor of overall mortality than BNP in this population.

Area of Science:

  • Nephrology
  • Cardiology
  • Biomarkers

Background:

  • B-type natriuretic peptide (BNP) is crucial for diagnosing and predicting cardiovascular disease.
  • Prospective data on baseline BNP and heart failure as mortality predictors in incident hemodialysis patients are limited.

Purpose of the Study:

  • To evaluate baseline BNP and heart failure as predictors of overall mortality in incident end-stage renal disease (ESRD) patients undergoing hemodialysis.
  • To investigate the independent predictive value of BNP and severe heart failure on mortality.

Main Methods:

  • An observational study included 255 ESRD patients with a median follow-up of 1.11 years.
  • Kaplan-Meier survival curves analyzed mortality rates stratified by baseline BNP levels (< 340 pg/ml vs. >= 340 pg/ml).
  • Univariate and multiple Cox regression models assessed predictors of death, including severe heart failure (New York Heart Association classification).

Main Results:

  • Higher baseline BNP concentrations were associated with significantly increased mortality.
  • Multiple Cox regression initially confirmed high BNP as an independent predictor of death.
  • However, when severe heart failure was included in the model, it emerged as a stronger predictor of overall death than BNP.

Conclusions:

  • Elevated baseline BNP levels predict mortality in incident dialysis patients.
  • Severe heart failure significantly influences the predictive impact of BNP on survival.
  • Severe heart failure may be a more potent predictor of overall mortality than BNP in this cohort.
Abstract

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