2007 JASN IMPACT FACTOR 7.111	HOME   AUTHOR INFO   EDITORIAL BOARD   SUBSCRIBE   FEEDBACK   ALERTS   HELP
advanced	CURRENT ISSUE	ARCHIVES	JASN Express	ONLINE SUBMISSION

This Article Full Text Full Text (PDF) All Versions of this Article: ASN.2005121299v1 18/1/321    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Wang, A. Y.-M. Articles by Sanderson, J. E. Search for Related Content PubMed PubMed Citation Articles by Wang, A. Y.-M. Articles by Sanderson, J. E. Related Collections Related Article

N-Terminal Pro-Brain Natriuretic Peptide: An Independent Risk Predictor of Cardiovascular Congestion, Mortality, and Adverse Cardiovascular Outcomes in Chronic Peritoneal Dialysis Patients

Angela Yee-Moon Wang^*, Christopher Wai-Kei Lam, Cheuk-Man Yu^*, Mei Wang^*, Iris Hiu-Shuen Chan, Yan Zhang^*, Siu-Fai Lui^* and John E. Sanderson^*

Departments of ^* Medicine & Therapeutics; and Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong

Address correspondence to: Dr. Angela Yee-Moon Wang, University Department of Medicine, University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong. Phone: +852-28554949; Fax: +852-28555411; aymwang{at}hkucc.hku.hk

Received for publication December 15, 2005. Accepted for publication October 19, 2006.

This study was performed to determine whether the N-terminal pro-brain natriuretic peptide (NT-pro-BNP) is a useful biomarker in predicting cardiovascular congestion, mortality, and cardiovascular death and event in chronic peritoneal dialysis (PD) patients. A prospective cohort study was conducted in 230 chronic PD patients in a dialysis unit of a university teaching hospital. Serum NT-pro-BNP was measured at baseline together with echocardiography and dialysis indices. Each patient was followed for 3 yr from the day of enrollment or until death. Time to develop first episode of cardiovascular congestion and other cardiovascular event and time to mortality and cardiovascular death were studied in relation to NT-pro-BNP. NT-pro-BNP showed the strongest correlation with residual GFR, followed by left ventricular ejection fraction and left ventricular mass index. In the univariate Cox regression model, NT-pro-BNP was a significant predictor of cardiovascular congestion, mortality, and cardiovascular death and event. In the fully adjusted multivariable Cox regression analysis that included residual GFR, left ventricular ejection fraction, and left ventricular mass index, the hazard ratios for cardiovascular congestion, mortality, composite end point of mortality and cardiovascular congestion, and cardiovascular death and event for patients of the fourth quartile were 4.25 (95% confidence interval [CI] 1.56 to 11.62; P = 0.005), 4.97 (95% CI 1.35 to 18.28; P = 0.016), 5.03 (95% CI 2.07 to 12.26; P < 0.001), 7.50 (95% CI 1.36 to 41.39; P = 0.021), and 9.10 (95% CI 2.46 to 33.67; P = 0.001), respectively, compared with the first quartile. These data showed that NT-pro-BNP is an important risk predictor of cardiovascular congestion, mortality, and adverse cardiovascular outcomes in chronic PD patients and adds important prognostic information beyond that contributed by left ventricular hypertrophy, systolic dysfunction, and other conventional risk factors.

Related Article

This Month’s Highlights
J. Am. Soc. Nephrol. 2007 18: 1-2. [Full Text] [PDF]

This article has been cited by other articles:

				S. J. Davies, E. G. Lopez, G. Woodrow, K. Donovan, J. Plum, P. Williams, A. C. Johansson, H.-P. Bosselmann, O. Heimburger, O. Simonsen, et al. Longitudinal relationships between fluid status, inflammation, urine volume and plasma metabolites of icodextrin in patients randomized to glucose or icodextrin for the long exchange Nephrol. Dial. Transplant., September 1, 2008; 23(9): 2982 - 2988. [Abstract] [Full Text] [PDF]

				K. Winkler, C. Wanner, C. Drechsler, J. Lilienthal, W. Marz, V. Krane, and for the German Diabetes and Dialysis Study Investi Change in N-terminal-pro-B-type-natriuretic-peptide and the risk of sudden death, stroke, myocardial infarction, and all-cause mortality in diabetic dialysis patients Eur. Heart J., September 1, 2008; 29(17): 2092 - 2099. [Abstract] [Full Text] [PDF]

				A. Y.-M. Wang and K.-N. Lai Use of Cardiac Biomarkers in End-Stage Renal Disease J. Am. Soc. Nephrol., September 1, 2008; 19(9): 1643 - 1652. [Abstract] [Full Text] [PDF]

				S. Niizuma, Y. Iwanaga, T. Yahata, Y. Goto, T. Kita, S. Miyazaki, and H. Nakahama Plasma B-type natriuretic peptide levels reflect the presence and severity of stable coronary artery disease in chronic haemodialysis patients Nephrol. Dial. Transplant., August 31, 2008; (2008) gfn491v1. [Abstract] [Full Text] [PDF]

				O. M. Gutierrez, H. Tamez, I. Bhan, J. Zazra, M. Tonelli, M. Wolf, J. L. Januzzi, Y. Chang, and R. Thadhani N-terminal Pro-B-Type Natriuretic Peptide (NT-proBNP) Concentrations in Hemodialysis Patients: Prognostic Value of Baseline and Follow-up Measurements Clin. Chem., August 1, 2008; 54(8): 1339 - 1348. [Abstract] [Full Text] [PDF]

				M. A. Roberts, P. M. Srivastava, N. Macmillan, D. L. Hare, S. Ratnaike, K. Sikaris, and F. L. Ierino B-type Natriuretic Peptides Strongly Predict Mortality in Patients Who Are Treated with Long-Term Dialysis Clin. J. Am. Soc. Nephrol., July 1, 2008; 3(4): 1057 - 1065. [Abstract] [Full Text] [PDF]

				B. Canaud Residual renal function: the delicate balance betweenbenefits and risks Nephrol. Dial. Transplant., June 1, 2008; 23(6): 1801 - 1805. [Full Text] [PDF]

				S. David, P. Kumpers, V. Seidler, F. Biertz, H. Haller, and D. Fliser Diagnostic value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) for left ventricular dysfunction in patients with chronic kidney disease stage 5 on haemodialysis Nephrol. Dial. Transplant., April 1, 2008; 23(4): 1370 - 1377. [Abstract] [Full Text] [PDF]

				P. Stenvinkel, J. J. Carrero, J. Axelsson, B. Lindholm, O. Heimburger, and Z. Massy Emerging Biomarkers for Evaluating Cardiovascular Risk in the Chronic Kidney Disease Patient: How Do New Pieces Fit into the Uremic Puzzle? Clin. J. Am. Soc. Nephrol., March 1, 2008; 3(2): 505 - 521. [Abstract] [Full Text] [PDF]

				R. Paniagua, D. Amato, S. Mujais, E. Vonesh, A. Ramos, R. Correa-Rotter, and W. H. Horl Predictive Value of Brain Natriuretic Peptides in Patients on Peritoneal Dialysis: Results from the ADEMEX Trial Clin. J. Am. Soc. Nephrol., March 1, 2008; 3(2): 407 - 415. [Abstract] [Full Text] [PDF]

Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673