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February 2, 20260 citationsOpen Access

Long-Term Outcomes in Hemodialysis Patients According to Combined NT-proBNP and Galectin-3 Biomarker Profiles

ASAnca Elena StefanACAdrian CovicMCMaria Covic

Key Result

Higher NT-proBNP levels were independently associated with increased all-cause mortality in hemodialysis patients compared with the reference group (adjusted HRs 2.58 and 1.93; p<0.05).

Key Points

  • This study investigates the relationship between NT-proBNP and galectin-3 levels and long-term mortality in hemodialysis patients.
  • Conducted a retrospective study with 173 clinically stable hemodialysis patients
  • Classified patients into four groups based on NT-proBNP and galectin-3 levels
  • Evaluated primary outcomes: all-cause mortality and major adverse cardiovascular events over 10 years
  • Assessed pulse wave velocity as an additional prognostic marker
  • 76.9% of patients died during follow-up period
  • Higher NT-proBNP levels correlated with increased mortality risk, with hazard ratios of 2.58 and 1.93
  • Age and pulse wave velocity were independently linked to increased mortality risk
  • 26.8% of patients experienced major adverse cardiovascular events, with no significant differences among biomarker-defined groups

Study Design

Type

Cohort (n=173)

Structured PICO

Do combined NT-proBNP and galectin-3 biomarker profiles predict long-term mortality and MACE in stable hemodialysis patients?

P
Population
173 clinically stable and asymptomatic hemodialysis patients followed for over 10 years.
E
Exposure
Elevated baseline NT-proBNP (≥4234 pg/mL) and/or galectin-3 (≥28.1 ng/mL)
C
Comparator
Reference group with lower baseline biomarker levels
O
Outcome
All-cause mortality and major adverse cardiovascular events (MACE)hard clinical

Elevated NT-proBNP and increased arterial stiffness (pulse wave velocity) are independent predictors of long-term all-cause mortality in stable hemodialysis patients.

Main Result

Hazard Ratio: 2.58

p-value: p=<0.05

Abstract

Background and Hypothesis: Mortality in hemodialysis (HD) remains high and is not fully explained by traditional risk factors. Biomarkers reflecting myocardial stress and fibrosis, together with measures of vascular stiffness, may provide additional prognostic information in this population. Methods: We conducted a retrospective study evaluating 173 HD patients who were clinically stable and asymptomatic at baseline over a follow-up period of over 10 years. Patients were classified into four groups based on median baseline values of NT-proBNP and galectin-3 (4234 pg/mL and 28.1 ng/mL, respectively). Primary outcomes were all-cause mortality and major adverse cardiovascular events (MACE). Pulse wave velocity (PWV) was evaluated as an additional prognostic marker. Results: During follow-up, 76.9% of patients died. Higher NT-proBNP levels were associated with increased all-cause mortality, irrespective of galectin-3 levels, with adjusted hazard ratios of 2.58 and 1.93 compared with the reference group (p < 0.05). Age and PWV were independently associated with mortality risk, corresponding to a 4% increase in risk per year of age and a 6% increase per 1 m/s increase in PWV. MACE occurred in 26.8% of patients and did not differ significantly between biomarker-defined groups. Conclusions: In this long-term HD cohort, elevated NT-proBNP and increased arterial stiffness were independently associated with higher all-cause mortality. These findings support the complementary prognostic value of markers of cardiac stress and vascular stiffness in chronic hemodialysis patients.

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Cite This Study

Stefan et al. (2026) conducted a cohort in Hemodialysis (n=173). Higher NT-proBNP levels vs. Reference group (lower NT-proBNP levels) was evaluated on All-cause mortality and major adverse cardiovascular events (MACE) (HR 2.58 and 1.93, p=<0.05). Higher NT-proBNP levels were independently associated with increased all-cause mortality in hemodialysis patients compared with the reference group (adjusted HRs 2.58 and 1.93; p<0.05).

synapsesocial.com/papers/6980ffe7c1c9540dea812bc9https://doi.org/10.3390/jcm15031129
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