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Prognostic efficacy of cardiac biomarkers for mortality in dialysis patients

P E Hickman1, D A McGill, G Talaulikar

  • 1Department of Chemical Pathology, The Canberra Hospital and Department of Pathology, ANU Medical School, Canberra, Australian Capital Territory, Australia. peter.hickman@act.gov.au

Internal Medicine Journal
|March 18, 2010
PubMed

Insights

In end-stage renal disease patients on dialysis, N-terminal pro-BNP (NT-pro-BNP) is a stronger predictor of mortality than troponin T (TnT) and troponin I (TnI). This finding aids in assessing cardiovascular risk in this vulnerable population.

Area of Science:

  • Cardiology
  • Nephrology
  • Biomarker Research

Background:

  • Cardiovascular mortality is high in end-stage renal disease (ESRD) patients.
  • Established cardiac biomarkers include troponin T (TnT), troponin I (TnI), B-type natriuretic peptide (BNP), and N-terminal pro-BNP (NT-pro-BNP).

Purpose of the Study:

  • To evaluate the prognostic significance of TnT, TnI, BNP, and NT-pro-BNP in ESRD patients.
  • To compare the predictive value of these cardiac biomarkers for all-cause mortality in dialysis patients.

Main Methods:

  • Prospective cohort study of 143 dialysis patients in Australia.
  • Collected clinical and biochemical data, including cardiac biomarkers.
  • Followed patients for a median of 30 months to record all-cause mortality.
  • Utilized Cox proportional hazards analysis to assess covariate-outcome relationships.

Main Results:

  • All tested cardiac markers (TnT, TnI, BNP, NT-pro-BNP) were associated with increased mortality in univariate analysis.
  • Multivariate Cox analysis identified only albumin and NT-pro-BNP as significant predictors of mortality.
  • NT-pro-BNP demonstrated a significant association with mortality (Hazard Ratio: 1.585, P = 0.004).

Conclusions:

  • N-terminal pro-BNP (NT-pro-BNP) offers superior prognostic information for mortality in ESRD patients on dialysis compared to TnT and TnI.
  • Albumin also showed prognostic value in this patient cohort.
Abstract

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