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NT-pro BNP level at dialysis initiation is a useful biomarker for predicting hospitalization for ischemic heart disease

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Abstract

Background

Patients with end-stage kidney disease (ESKD) are at high risk of cardiovascular disease including stroke, heart failure, and ischemic heart disease (IHD). To prevent the occurrence and progression of CVD, a reliable prognostic cardiac biomarker is essential. We investigated the prognostic value of NT-proBNP for each incident type of CVD.

Methods

Male patients from the Ibaraki Dialysis Initiation Cohort (iDIC) study with preserved serum samples from dialysis initiation day (n = 212) were analyzed. Patients were classified into four groups according to quartiles of baseline NT-pro BNP levels. The relationship between NT-proBNP levels at the initiation of dialysis and the subsequent incidence of hospitalization events due to IHD, heart failure, and stroke was analyzed.

Results

The incidence rate for hospitalization due to IHD was significantly higher in the highest NT-proBNP category (Log rank p = 0.008); those of stroke and heart failure showed no significant differences among quartiles. Cox proportional hazards regression analysis revealed that serum NT-proBNT was the only prognostic factor for hospitalization for IHD after adjustment by major known IHD risk factors. (HR, 1.008; 95% confidence interval, 1.002–1.014; p = 0.01) The ROC curve analysis for the incidence of hospitalization due to IHD showed that NT-proBNP had an area under the curve (AUC) of 0.759 (95% CI 0.622–0.897; p = 0.004) at a cut-off value of 956.6 pg/mL.

Conclusion

NT-proBNP measurement at the initiation of dialysis therapy is useful to predict later hospitalization for IHD.

Trial registration: UMIN000010806.

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Authors and Affiliations

  1. Department of Nephrology, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, Ami, Inashiki, Ibaraki, 300-0395, Japan

    Homare Shimohata, Daichi Numajiri, Ayaka Kaneshige, Masatoshi Sega, Marina Yamashita, Kentaro Ohgi, Hiroshi Maruyama, Mamiko Takayasu & Kouichi Hirayama

  2. Department of Nephrology, Faculty of Medicine, University of Tsukuba, Ibaraki, Tsukuba, Japan

    Joichi Usui & Kunihiro Yamagata

  3. Department of Nephrology, Mito Kyodo General Hospital, Ibaraki, Mito, Japan

    Takashi Tawara-Iida

  4. Department of Nephrology, Mito Saiseikai General Hospital, Ibaraki, Mito, Japan

    Itaru Ebihara

  5. Department of Nephrology, Ushiku Aiwa General Hospital, Ibaraki, Ushiku, Japan

    Takashi Ishizu

  6. Nephrology Division, Department of Internal Medicine, JA Toride Medical Center, Ibaraki, Toride, Japan

    Yoshitaka Maeda

  7. Department of Nephrology, Ibaraki Prefectural Center Hospital, Ibaraki, Kasama, Japan

    Hiroaki Kobayashi

  8. Ohba Medical Clinic, Ibaraki, Mito, Japan

    Masaki Kobayashi

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  1. Homare Shimohata
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  2. Joichi Usui
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  15. Kouichi Hirayama
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the Study Group of the Ibaraki Dialysis Initiation Cohort Study

Corresponding author

Correspondence to Homare Shimohata.

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The authors have declared that no conflicts of interest exist.

Ethical approval

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee at the institutions where the studies were conducted (IRB approval number IB1308) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

The Study Group of the Ibaraki Dialysis Initiation Cohort Study

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Shimohata, H., Usui, J., Tawara-Iida, T. et al. NT-pro BNP level at dialysis initiation is a useful biomarker for predicting hospitalization for ischemic heart disease. Clin Exp Nephrol 28, 457–464 (2024). https://doi.org/10.1007/s10157-023-02442-x

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  • DOI: https://doi.org/10.1007/s10157-023-02442-x

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