Key result
Higher NT-proBNP is linked to ~13% higher risk of peritoneal dialysis technique failure.
Why the study?
It was unclear whether NT-proBNP level can serve as a biomarker for technique failure among long-term peritoneal dialysis patients.
Does NT-proBNP level predict technique failure and mortality in patients undergoing peritoneal dialysis?
Cohort (n=258)
No
Does NT-proBNP level predict technique failure and mortality in patients undergoing peritoneal dialysis?
Elevated NT-proBNP levels independently predict technique failure and mortality in patients undergoing long-term peritoneal dialysis.
May support risk stratification in peritoneal dialysis; leaves open need for prospective validation before guiding care.
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, p < 0.01) were predictive of an increased risk of technique failure, and were also predictive of an increased risk of mortality (HR 1.56, p < 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.
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Chao et al. (2018) conducted a cohort in End-stage renal disease undergoing peritoneal dialysis (n=258). Elevated N-terminal pro-brain natriuretic peptide (NT-proBNP) levels vs. Lower NT-proBNP levels was evaluated on Technique failure (transition of ESRD therapeutic modality from peritoneal dialysis to hemodialysis for ≥1 month) (HR 1.13, p=<0.01). Higher natural log transformed NT-proBNP levels independently predicted an increased risk of technique failure (HR 1.13, p < 0.01) and mortality among patients on long-term peritoneal dialysis.
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