Chen Yi-Hsin, Fu Yun-Ching, Wu Ming-Ju
Institute of Clinical Medicine, National Yang-Ming University, Taipei 112, Taiwan.
Department of Nephrology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427, Taiwan.
J Clin Med. 2019 Feb 12;8(2):238. doi: 10.3390/jcm8020238.
N-terminal pro b-type natriuretic peptide (NT-proBNP) was considered a prognostic factor for mortality in hemodialysis patients in previous studies. However, NT-proBNP has not been fully explored in terms of predicting other clinical outcomes in hemodialysis patients. This study aimed to investigate if NT-proBNP could predict emergency department (ED) visits, hospitalization, admission to intensive-care unit (ICU), and cardiovascular incidents in hemodialysis patients. Serum NT-proBNP and other indicators were collected in 232 hemodialysis patients. Patients were followed up for three years or until mortality. Outcomes included mortality, number of ED visits, hospitalizations, admissions to ICU, and cardiovascular events. NT-proBNP was found to predict recurrent ER visits, hospitalization, admission to ICU, cardiovascular events, and mortality, after adjusting for covariates. Time-dependent area under the curve (AUC) was used to evaluate the NT-proBNP predicting ability. Using time-dependent AUC, NT-proBNP has good predictive ability for mortality, ED visit, hospitalization, ICU admission, and cardiovascular events with the best predictive ability occurring at approximately 1 year, and 5th, 62nd, 63rd, and 63rd days respectively. AUC values for predicting mortality, hospitalization, and ICU admission decreased significantly after one year. NT-proBNP can be applied in predicting ED visits but is only suitable for the short-term. NT-proBNP may be used for predicting mortality in the long term.
N末端前体b型利钠肽(NT-proBNP)在先前的研究中被认为是血液透析患者死亡率的一个预后因素。然而,在预测血液透析患者的其他临床结局方面,NT-proBNP尚未得到充分研究。本研究旨在调查NT-proBNP是否能够预测血液透析患者的急诊科就诊、住院、重症监护病房(ICU)收治情况以及心血管事件。收集了232例血液透析患者的血清NT-proBNP及其他指标。对患者进行了三年的随访或直至死亡。结局包括死亡率、急诊科就诊次数、住院次数、ICU收治情况以及心血管事件。在校正协变量后,发现NT-proBNP能够预测再次急诊就诊、住院、ICU收治、心血管事件以及死亡率。采用时间依赖性曲线下面积(AUC)来评估NT-proBNP的预测能力。利用时间依赖性AUC,NT-proBNP对死亡率、急诊科就诊、住院、ICU收治以及心血管事件具有良好的预测能力,最佳预测能力分别出现在约1年时以及第5天、第62天、第63天和第63天。预测死亡率、住院和ICU收治的AUC值在一年后显著下降。NT-proBNP可用于预测急诊科就诊情况,但仅适用于短期。NT-proBNP可能可用于长期预测死亡率。