Document Detail

N-terminal pro brain natriuretic peptide predicts mortality in patients with end-stage renal disease in hemodialysis.
MedLine Citation:
PMID:  17299526     Owner:  NLM     Status:  MEDLINE    
Concentrations of N-terminal pro brain natriuretic peptide (NT-proBNP) increase in patients with heart failure and other cardiovascular (CV) diseases and are strong prognostic markers. In patients with end-stage renal disease (ESRD) in hemodialysis (HD), levels of NT-proBNP are almost always raised. In ESRD patients undergoing HD, we aimed at (i) identifying the factors that affect levels of NT-proBNP, (ii) determining the effect of HD on NT-proBNP, and (iii) determining the prognostic impact of NT-proBNP. A total of 109 patients underwent physical examination, electrocardiogram, and echocardiography. Serum NT-proBNP was measured before and after HD (Elecsys 2010). NT-proBNP levels were markedly elevated (pre-HD 4079 pg/ml, post-HD 2759 pg/ml, P<0.001). There was a strong inverse correlation between NT-proBNP and left ventricular ejection fraction (LVEF) (P=0.043), 24-h urine production (P=0.006), and K(t)/V (efficacy of dialysis) (P=0.016) and a positive correlation with left ventricular hypertrophy (LVH) (P=0.014). Patients with higher concentrations, both pre- and post-HD had an increased mortality rate compared to those with lower concentrations (P=0.007, P=0.002). We found age (P=0.009) and NT-proBNP (pre-HD P=0.007, post-HD P=0.001) predictive of death. Our findings demonstrate that CV disease in terms of LVH and reduced LVEF in addition to 24-h urine production and K(t)/V determine NT-proBNP levels. Post-HD levels of NT-proBNP were lower than pre-HD levels; both predictive of mortality.
L H Madsen; S Ladefoged; P Corell; M Schou; P R Hildebrandt; D Atar
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-02-14
Journal Detail:
Title:  Kidney international     Volume:  71     ISSN:  0085-2538     ISO Abbreviation:  Kidney Int.     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-03-08     Completed Date:  2007-06-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0323470     Medline TA:  Kidney Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  548-54     Citation Subset:  IM    
Department of Cardiology and Endocrinology, Frederiksberg University Hospital, Copenhagen, Denmark.
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MeSH Terms
Aged, 80 and over
Biological Markers / blood
Cardiovascular Diseases / blood,  diagnosis,  etiology
Kidney Failure, Chronic / blood*,  diagnosis,  therapy*
Middle Aged
Natriuretic Peptide, Brain / blood*,  physiology
Peptide Fragments / blood*,  physiology
Predictive Value of Tests
Regression Analysis
Renal Dialysis / mortality*
Risk Factors
Stroke Volume / physiology
Ventricular Dysfunction, Left / blood,  diagnosis,  etiology
Reg. No./Substance:
0/Biological Markers; 0/Peptide Fragments; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain
Comment In:
Kidney Int. 2007 Mar;71(6):481-3   [PMID:  17344896 ]

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