Diagnostic value of B-type natriuretic peptide for estimating left atrial size and its usefulness for predicting all-cause mortality and cardiovascular events among chronic haemodialysis patients

Junichi Ishigami, Soichiro Iimori, Michio Kuwahara, Sei Sasaki, Yusuke Tsukamoto

Research output: Contribution to journalArticle

Abstract

Aim Estimating fluid balance in haemodialysis patients is essential when determining dry weight, but limited methods are currently available. B-type natriuretic peptide (BNP) is a useful surrogate marker in patients with congestive heart failure (CHF), but whether its validity could be generalized to haemodialysis patients has not been studied well. Methods A total of 457 haemodialysis patients at a dialysis centre were analyzed. Determinants of BNP were assessed in connection with ultrasound cardiography (UCG) records, Kt/V, ultrafiltration rate (UFR), and demographic factors. All-cause death and cardiovascular (CV) events were recorded as the main outcome. Results Among the UCG records, left atrial diameter (LAD), left ventricular ejection fraction (LVEF), were determinants of log-transformed (ln) BNP; UFR, age and sex were also significant. There was a positive correlation between BNP and LAD (r = 0.285, P < 0.001). Receiver operating characteristic (ROC) analysis revealed that BNP had 90% and 80% sensitivity to predict the presence of LA enlargement of 77.9 pg/mL and 133.2 pg/mL, respectively. Higher BNP and lower LVEF were associated with higher risk for developing all-cause death and CVD. In the adjusted model, patients with BNP higher than 471 pg/mL had hazard ratio of 2.18 (95% confidence interval (CI) 1.20-3.96, P = 0.01), compared to those with BNP <109 pg/mL. Conclusion B-type natriuretic peptide was determined by LAD, LVEF, UFR, age and sex. BNP and LAD had positive correlation and BNP could become a useful tool for estimating the presence of LA enlargement. BNP and LVEF was a strong risk factor for predicting all-cause death and CV events among patients undergoing haemodialysis.

Original languageEnglish (US)
Pages (from-to)777-783
Number of pages7
JournalNephrology
Volume19
Issue number12
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

Fingerprint

Brain Natriuretic Peptide
Renal Dialysis
Mortality
Stroke Volume
Ultrafiltration
Cause of Death
Water-Electrolyte Balance
ROC Curve
Dialysis
Heart Failure
Biomarkers
Demography
Confidence Intervals

Keywords

  • B-type natriuretic peptide
  • cardiovascular disease
  • chronic kidney disease
  • haemodialysis
  • ultrasound cardiography

ASJC Scopus subject areas

  • Nephrology

Cite this

Diagnostic value of B-type natriuretic peptide for estimating left atrial size and its usefulness for predicting all-cause mortality and cardiovascular events among chronic haemodialysis patients. / Ishigami, Junichi; Iimori, Soichiro; Kuwahara, Michio; Sasaki, Sei; Tsukamoto, Yusuke.

In: Nephrology, Vol. 19, No. 12, 01.01.2014, p. 777-783.

Research output: Contribution to journalArticle

@article{7e1738713e82470eaa5cbb775c39fdab,
title = "Diagnostic value of B-type natriuretic peptide for estimating left atrial size and its usefulness for predicting all-cause mortality and cardiovascular events among chronic haemodialysis patients",
abstract = "Aim Estimating fluid balance in haemodialysis patients is essential when determining dry weight, but limited methods are currently available. B-type natriuretic peptide (BNP) is a useful surrogate marker in patients with congestive heart failure (CHF), but whether its validity could be generalized to haemodialysis patients has not been studied well. Methods A total of 457 haemodialysis patients at a dialysis centre were analyzed. Determinants of BNP were assessed in connection with ultrasound cardiography (UCG) records, Kt/V, ultrafiltration rate (UFR), and demographic factors. All-cause death and cardiovascular (CV) events were recorded as the main outcome. Results Among the UCG records, left atrial diameter (LAD), left ventricular ejection fraction (LVEF), were determinants of log-transformed (ln) BNP; UFR, age and sex were also significant. There was a positive correlation between BNP and LAD (r = 0.285, P < 0.001). Receiver operating characteristic (ROC) analysis revealed that BNP had 90{\%} and 80{\%} sensitivity to predict the presence of LA enlargement of 77.9 pg/mL and 133.2 pg/mL, respectively. Higher BNP and lower LVEF were associated with higher risk for developing all-cause death and CVD. In the adjusted model, patients with BNP higher than 471 pg/mL had hazard ratio of 2.18 (95{\%} confidence interval (CI) 1.20-3.96, P = 0.01), compared to those with BNP <109 pg/mL. Conclusion B-type natriuretic peptide was determined by LAD, LVEF, UFR, age and sex. BNP and LAD had positive correlation and BNP could become a useful tool for estimating the presence of LA enlargement. BNP and LVEF was a strong risk factor for predicting all-cause death and CV events among patients undergoing haemodialysis.",
keywords = "B-type natriuretic peptide, cardiovascular disease, chronic kidney disease, haemodialysis, ultrasound cardiography",
author = "Junichi Ishigami and Soichiro Iimori and Michio Kuwahara and Sei Sasaki and Yusuke Tsukamoto",
year = "2014",
month = "1",
day = "1",
doi = "10.1111/nep.12329",
language = "English (US)",
volume = "19",
pages = "777--783",
journal = "Nephrology",
issn = "1320-5358",
publisher = "Wiley-Blackwell",
number = "12",

}

TY - JOUR

T1 - Diagnostic value of B-type natriuretic peptide for estimating left atrial size and its usefulness for predicting all-cause mortality and cardiovascular events among chronic haemodialysis patients

AU - Ishigami, Junichi

AU - Iimori, Soichiro

AU - Kuwahara, Michio

AU - Sasaki, Sei

AU - Tsukamoto, Yusuke

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Aim Estimating fluid balance in haemodialysis patients is essential when determining dry weight, but limited methods are currently available. B-type natriuretic peptide (BNP) is a useful surrogate marker in patients with congestive heart failure (CHF), but whether its validity could be generalized to haemodialysis patients has not been studied well. Methods A total of 457 haemodialysis patients at a dialysis centre were analyzed. Determinants of BNP were assessed in connection with ultrasound cardiography (UCG) records, Kt/V, ultrafiltration rate (UFR), and demographic factors. All-cause death and cardiovascular (CV) events were recorded as the main outcome. Results Among the UCG records, left atrial diameter (LAD), left ventricular ejection fraction (LVEF), were determinants of log-transformed (ln) BNP; UFR, age and sex were also significant. There was a positive correlation between BNP and LAD (r = 0.285, P < 0.001). Receiver operating characteristic (ROC) analysis revealed that BNP had 90% and 80% sensitivity to predict the presence of LA enlargement of 77.9 pg/mL and 133.2 pg/mL, respectively. Higher BNP and lower LVEF were associated with higher risk for developing all-cause death and CVD. In the adjusted model, patients with BNP higher than 471 pg/mL had hazard ratio of 2.18 (95% confidence interval (CI) 1.20-3.96, P = 0.01), compared to those with BNP <109 pg/mL. Conclusion B-type natriuretic peptide was determined by LAD, LVEF, UFR, age and sex. BNP and LAD had positive correlation and BNP could become a useful tool for estimating the presence of LA enlargement. BNP and LVEF was a strong risk factor for predicting all-cause death and CV events among patients undergoing haemodialysis.

AB - Aim Estimating fluid balance in haemodialysis patients is essential when determining dry weight, but limited methods are currently available. B-type natriuretic peptide (BNP) is a useful surrogate marker in patients with congestive heart failure (CHF), but whether its validity could be generalized to haemodialysis patients has not been studied well. Methods A total of 457 haemodialysis patients at a dialysis centre were analyzed. Determinants of BNP were assessed in connection with ultrasound cardiography (UCG) records, Kt/V, ultrafiltration rate (UFR), and demographic factors. All-cause death and cardiovascular (CV) events were recorded as the main outcome. Results Among the UCG records, left atrial diameter (LAD), left ventricular ejection fraction (LVEF), were determinants of log-transformed (ln) BNP; UFR, age and sex were also significant. There was a positive correlation between BNP and LAD (r = 0.285, P < 0.001). Receiver operating characteristic (ROC) analysis revealed that BNP had 90% and 80% sensitivity to predict the presence of LA enlargement of 77.9 pg/mL and 133.2 pg/mL, respectively. Higher BNP and lower LVEF were associated with higher risk for developing all-cause death and CVD. In the adjusted model, patients with BNP higher than 471 pg/mL had hazard ratio of 2.18 (95% confidence interval (CI) 1.20-3.96, P = 0.01), compared to those with BNP <109 pg/mL. Conclusion B-type natriuretic peptide was determined by LAD, LVEF, UFR, age and sex. BNP and LAD had positive correlation and BNP could become a useful tool for estimating the presence of LA enlargement. BNP and LVEF was a strong risk factor for predicting all-cause death and CV events among patients undergoing haemodialysis.

KW - B-type natriuretic peptide

KW - cardiovascular disease

KW - chronic kidney disease

KW - haemodialysis

KW - ultrasound cardiography

UR - http://www.scopus.com/inward/record.url?scp=84936745929&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84936745929&partnerID=8YFLogxK

U2 - 10.1111/nep.12329

DO - 10.1111/nep.12329

M3 - Article

C2 - 25142830

AN - SCOPUS:84936745929

VL - 19

SP - 777

EP - 783

JO - Nephrology

JF - Nephrology

SN - 1320-5358

IS - 12

ER -