Chao Chia-Ter, Chiang Chih-Kang, Huang Jenq-Wen, Hung And Kuan-Yu
Department of Medicine, National Taiwan University Hospital BeiHu Branch, College of Medicine, National Taiwan University, Taipei 108, Taiwan.
Department of Integrative Diagnostics and Therapeutics, National Taiwan University Hospital, Taipei 100, Taiwan.
J Clin Med. 2018 Dec 16;7(12):557. doi: 10.3390/jcm7120557.
It is unclear whether N-terminal pro-brain type natriuretic peptide (NT-proBNP) level can be a biomarker for technique failure among long-term peritoneal dialysis (PD) patients. We prospectively included end-stage renal disease patients undergoing PD from a single center between December 2011 and December 2017. We divided the cohort into high or low NT-proBNP groups and analyzed the risk factors associated with the incidence of technique failure using Cox proportional hazard regression analysis. A total of 258 chronic PD patients (serum NT-proBNP, 582 ± 1216 ng/mL) were included. After a mean follow-up of 3.6 years, 49.6% of PD patients developed technique failure and switched to hemodialysis, while 15.5% died. Cox proportional hazard regression analyses accounting for age, gender, diabetes, renal clearance, C-reactive protein, and hydration status, showed that higher natural log transformed NT-proBNP levels (hazard ratio [HR] 1.13, < 0.01) were predictive of an increased risk of technique failure, and were also predictive of an increased risk of mortality (HR 1.56, < 0.01). Consequently, NT-proBNP might be an under-recognized biomarker for estimating the risk of technique failure, and regular monitoring NT-proBNP levels among PD patients may assist in their care.
N末端前脑钠肽（NT-proBNP）水平能否作为长期腹膜透析（PD）患者技术失败的生物标志物尚不清楚。我们前瞻性纳入了2011年12月至2017年12月期间来自单一中心的接受PD治疗的终末期肾病患者。我们将队列分为NT-proBNP高组或低组，并使用Cox比例风险回归分析来分析与技术失败发生率相关的危险因素。总共纳入了258例慢性PD患者（血清NT-proBNP，582±1216 ng/mL）。经过平均3.6年的随访，49.6%的PD患者出现技术失败并转为血液透析，而15.5%的患者死亡。对年龄、性别、糖尿病、肾脏清除率、C反应蛋白和水合状态进行Cox比例风险回归分析，结果显示，自然对数转换后的较高NT-proBNP水平（风险比[HR] 1.13，<0.01）可预测技术失败风险增加，也可预测死亡风险增加（HR 1.56，<0.01）。因此，NT-proBNP可能是一种未被充分认识的用于评估技术失败风险的生物标志物，定期监测PD患者的NT-proBNP水平可能有助于其治疗。
