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
N1 - Publisher Copyright:
© 2014 Asian Pacific Society of Nephrology.
PY - 2014/12/1
Y1 - 2014/12/1
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
SN - 1320-5358
VL - 19
SP - 777
EP - 783
JO - Nephrology
JF - Nephrology
IS - 12
ER -