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NT-pro BNP level at dialysis initiation is a useful biomarker for predicting hospitalization for ischemic heart

Homare Shimohata1, Joichi Usui2, Takashi Tawara-Iida3

  • 1Department of Nephrology, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, Ami, Inashiki, Ibaraki, 300-0395, Japan. h-shimo@tokyo-med.ac.jp.

Clinical and Experimental Nephrology
|January 18, 2024
PubMed

Insights

N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels at dialysis initiation predict ischemic heart disease (IHD) hospitalization in end-stage kidney disease (ESKD) patients. This biomarker aids in assessing cardiovascular risk for ESKD patients.

Area of Science:

  • Nephrology
  • Cardiology
  • Biomarker Research

Background:

  • Patients with end-stage kidney disease (ESKD) face elevated risks of cardiovascular disease (CVD), including stroke, heart failure, and ischemic heart disease (IHD).
  • A reliable prognostic cardiac biomarker is crucial for preventing CVD occurrence and progression in ESKD patients.
  • This study investigated the prognostic value of NT-proBNP for incident CVD types.

Purpose of the Study:

  • To evaluate the prognostic value of NT-proBNP in predicting cardiovascular events in ESKD patients.
  • To determine if NT-proBNP levels at dialysis initiation can predict hospitalization for IHD, heart failure, or stroke.

Main Methods:

  • Analysis of serum samples from 212 male patients at dialysis initiation from the Ibaraki Dialysis Initiation Cohort (iDIC) study.
  • Patients were stratified into four groups based on baseline NT-proBNP quartiles.
  • Association between NT-proBNP levels and subsequent hospitalization for IHD, heart failure, and stroke was analyzed.

Main Results:

  • Higher NT-proBNP levels were significantly associated with increased IHD hospitalization rates (Log rank p=0.008).
  • NT-proBNP was the sole significant prognostic factor for IHD hospitalization after adjusting for major risk factors (HR=1.008, p=0.01).
  • ROC analysis indicated NT-proBNP's predictive capability for IHD hospitalization with an AUC of 0.759 at a cutoff of 956.6 pg/mL.

Conclusions:

  • NT-proBNP measurement at dialysis initiation is a valuable tool for predicting future IHD hospitalizations.
  • This biomarker can aid clinicians in risk stratification for cardiovascular events in ESKD patients.
Abstract

Keywords:
DialysisHospitalizationIschemic heart diseaseNT-proBNP

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