NT-ProBNP Predicts Total Mortality, Emergency Department Visits, Hospitalization, Intensive-Care Unit Admission, and Cardiovascular Events in Hemodialysis Patients

Yun‐Ching Fu; Ming‐Ju Wu

doi:10.3390/jcm8020238

February 12, 2019Journal of Clinical MedicineOpen Access

NT-ProBNP Predicts Total Mortality, Emergency Department Visits, Hospitalization, Intensive-Care Unit Admission, and Cardiovascular Events in Hemodialysis Patients

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Why the study?

Although NT-proBNP is known to predict mortality in hemodialysis patients, its ability to predict other clinical outcomes has not been fully explored.

Does serum NT-proBNP predict mortality, ED visits, hospitalization, ICU admission, and cardiovascular events in hemodialysis patients?

Structured PICO

Does serum NT-proBNP predict mortality, ED visits, hospitalization, ICU admission, and cardiovascular events in hemodialysis patients?

P

Population

232 hemodialysis patients

I

Intervention

Serum NT-proBNP measurement

O

Outcome

Mortality, number of emergency department (ED) visits, hospitalizations, admissions to intensive-care unit (ICU), and cardiovascular eventshard clinical

NT-proBNP is a useful biomarker for predicting short-term clinical events (ED visits, hospitalizations, ICU admissions, CV events) and long-term mortality in hemodialysis patients.

Implication

NT-proBNP may aid risk stratification in hemodialysis patients; hypothesis-generating for timed interventions and prospective validation.

Abstract

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.