Abstract | AIM: METHODS: A cross-sectional study involving 71 (68 ± 14 years, 83% male) new dialysis patients was conducted. Receiver operator characteristic curve analysis was performed to identify the cutoff level of NT-proBNP for identifying cardiac disease at the start of dialysis. RESULTS: The median NT-proBNP concentration was 6576 pg/mL just before the first dialysis session and its mean digit number was 4.3 ± 0.6. Overall, 67%, 52%, 9% and 35% of patients had left ventricular (LV) hypertrophy, LV dilatation, systolic dysfunction and significant coronary artery disease, respectively. NT-proBNP levels of about 6000, 10,000 and 14,000 pg/mL were the best cutoff levels for the diagnosis of coronary artery disease (AUC, 0.754; P < 0.001), LV systolic dysfunction (area under the curve (AUC), 0.765, P = 0.001) and LV dilatation (AUC, 0.685, P = 0.008), respectively. Interestingly, 4.5 was the best digit number cutoff for all cardiac abnormalities. These findings suggest that a digit number of 5 or more means a potentially high risk for cardiovascular disease and a digit number of 3 or less means a relatively low risk. CONCLUSIONS: The NT-proBNP concentration just before the first dialysis session is a useful tool for screening for cardiac abnormalities. Considering the wide variation of the NT-proBNP cutoff levels depending on each cardiac abnormality, the digit number could be potentially easier to use for initial risk stratification for cardiac disease in new dialysis patients.
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Authors | Masaki Iwasaki, Nobuhiko Joki, Yuri Tanaka, Nobutaka Ikeda, Toshihide Hayashi, Shun Kubo, Takasuke Asakawa, Yasunori Takahashi, Koichi Hirahata, Yoshihiko Imamura, Hiroki Hase |
Journal | Nephrology (Carlton, Vic.)
(Nephrology (Carlton))
Vol. 18
Issue 7
Pg. 497-504
(Jul 2013)
ISSN: 1440-1797 [Electronic] Australia |
PMID | 23574011
(Publication Type: Evaluation Study, Journal Article)
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Copyright | © 2013 The Authors. Nephrology © 2013 Asian Pacific Society of Nephrology. |
Chemical References |
- Biomarkers
- Peptide Fragments
- pro-brain natriuretic peptide (1-76)
- Natriuretic Peptide, Brain
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Topics |
- Aged
- Aged, 80 and over
- Area Under Curve
- Biomarkers
(blood)
- Coronary Artery Disease
(blood, diagnosis)
- Cross-Sectional Studies
- Female
- Heart Diseases
(blood, diagnosis, epidemiology)
- Humans
- Hypertrophy, Left Ventricular
(blood, diagnosis)
- Japan
(epidemiology)
- Kidney Failure, Chronic
(diagnosis, epidemiology, therapy)
- Linear Models
- Male
- Middle Aged
- Multivariate Analysis
- Natriuretic Peptide, Brain
(blood)
- Peptide Fragments
(blood)
- Predictive Value of Tests
- Prevalence
- ROC Curve
- Renal Dialysis
- Risk Assessment
- Risk Factors
- Up-Regulation
- Ventricular Dysfunction, Left
(blood, diagnosis)
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