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Prognostic value of cardiac biomarkers for death in a non-dialysis chronic kidney disease population.
Nephrol Dial Transplant. 2008 Nov; 23(11):3546-53.ND

Abstract

BACKGROUND

Excess mortality in patients with chronic kidney disease (CKD) is predominantly due to cardiovascular disease. We explored the prognostic value of biomarkers of cardiac overload [B-type natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP)] and inflammation [high-sensitivity C-reactive protein (hsCRP)] for all-cause mortality in patients with CKD.

METHODS

Plasma BNP (Siemens Medical Solutions Diagnostics, Frimley, Surrey, UK) and NT-proBNP (Roche Diagnostics PLC, East Sussex, UK), and hsCRP (Siemens Medical Solutions Diagnostics) were measured at study entry. Echocardiograms were undertaken, and left ventricular mass index (LVMI) was calculated. CKD patients (n = 213) were followed for up to 53 months. Kaplan-Meier survival analysis with log-rank testing and hazards ratios (HRs) were calculated for each cardiac biomarker, stratified by respective median values, as a predictor of death to assess outcome.

RESULTS

Fifty-four deaths occurred. NT-proBNP concentration >or=89 pmol/L (HR 5.6, P < 0.0001), BNP concentration >or=14 pmol/L (HR 3.5, P < 0.001), NT-proBNP/BNP ratio >or=6 pmol/pmol (HR 2.6, P < 0.01) and hsCRP concentration >or=4.7 mg/L (HR 2.4, P < 0.01) were unadjusted predictors of death. Only NT-proBNP >or=89 pmol/L (HR 2.5, P < 0.05) and hsCRP >or=4.7 mg/L (HR 1.9, P < 0.05) were independent predictors of death when the HRs were adjusted for significant clinical variables (age, estimated glomerular filtration rate, LVMI and vascular disease).

CONCLUSION

NT-proBNP and hsCRP can independently predict all-cause mortality in a non-dialysis CKD population and may have a useful role in risk stratification.

Authors+Show Affiliations

Department of Clinical Biochemistry, East Kent Hospitals NHS Trust, Kent and Canterbury Hospital, Canterbury, Kent, UK. susan.vickery@ekht.nhs.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18562472

Citation

Vickery, Susan, et al. "Prognostic Value of Cardiac Biomarkers for Death in a Non-dialysis Chronic Kidney Disease Population." Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, vol. 23, no. 11, 2008, pp. 3546-53.
Vickery S, Webb MC, Price CP, et al. Prognostic value of cardiac biomarkers for death in a non-dialysis chronic kidney disease population. Nephrol Dial Transplant. 2008;23(11):3546-53.
Vickery, S., Webb, M. C., Price, C. P., John, R. I., Abbas, N. A., & Lamb, E. J. (2008). Prognostic value of cardiac biomarkers for death in a non-dialysis chronic kidney disease population. Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, 23(11), 3546-53. https://doi.org/10.1093/ndt/gfn341
Vickery S, et al. Prognostic Value of Cardiac Biomarkers for Death in a Non-dialysis Chronic Kidney Disease Population. Nephrol Dial Transplant. 2008;23(11):3546-53. PubMed PMID: 18562472.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prognostic value of cardiac biomarkers for death in a non-dialysis chronic kidney disease population. AU - Vickery,Susan, AU - Webb,Michelle C, AU - Price,Christopher P, AU - John,Robert Ian, AU - Abbas,Nasir A, AU - Lamb,Edmund J, Y1 - 2008/06/18/ PY - 2008/6/20/pubmed PY - 2009/3/3/medline PY - 2008/6/20/entrez SP - 3546 EP - 53 JF - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JO - Nephrol Dial Transplant VL - 23 IS - 11 N2 - BACKGROUND: Excess mortality in patients with chronic kidney disease (CKD) is predominantly due to cardiovascular disease. We explored the prognostic value of biomarkers of cardiac overload [B-type natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP)] and inflammation [high-sensitivity C-reactive protein (hsCRP)] for all-cause mortality in patients with CKD. METHODS: Plasma BNP (Siemens Medical Solutions Diagnostics, Frimley, Surrey, UK) and NT-proBNP (Roche Diagnostics PLC, East Sussex, UK), and hsCRP (Siemens Medical Solutions Diagnostics) were measured at study entry. Echocardiograms were undertaken, and left ventricular mass index (LVMI) was calculated. CKD patients (n = 213) were followed for up to 53 months. Kaplan-Meier survival analysis with log-rank testing and hazards ratios (HRs) were calculated for each cardiac biomarker, stratified by respective median values, as a predictor of death to assess outcome. RESULTS: Fifty-four deaths occurred. NT-proBNP concentration >or=89 pmol/L (HR 5.6, P < 0.0001), BNP concentration >or=14 pmol/L (HR 3.5, P < 0.001), NT-proBNP/BNP ratio >or=6 pmol/pmol (HR 2.6, P < 0.01) and hsCRP concentration >or=4.7 mg/L (HR 2.4, P < 0.01) were unadjusted predictors of death. Only NT-proBNP >or=89 pmol/L (HR 2.5, P < 0.05) and hsCRP >or=4.7 mg/L (HR 1.9, P < 0.05) were independent predictors of death when the HRs were adjusted for significant clinical variables (age, estimated glomerular filtration rate, LVMI and vascular disease). CONCLUSION: NT-proBNP and hsCRP can independently predict all-cause mortality in a non-dialysis CKD population and may have a useful role in risk stratification. SN - 1460-2385 UR - https://www.unboundmedicine.com/medline/citation/18562472/Prognostic_value_of_cardiac_biomarkers_for_death_in_a_non_dialysis_chronic_kidney_disease_population_ L2 - https://academic.oup.com/ndt/article-lookup/doi/10.1093/ndt/gfn341 DB - PRIME DP - Unbound Medicine ER -