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J. Clin. Med. 2019, 8(2), 238; https://doi.org/10.3390/jcm8020238

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

1,2,3
,
1,4
and
1,5,6,7,8,*
1
Institute of Clinical Medicine, National Yang-Ming University, Taipei 112, Taiwan
2
Department of Nephrology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427, Taiwan
3
School of Medicine, Tzu Chi University, Hualien 907, Taiwan
4
Section of Pediatric Cardiology, Department of Pediatrics, Taichung Veterans General Hospital, Taichung 407, Taiwan
5
School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
6
School of Medicine, College of Medicine, China Medical University, Taichung 404, Taiwan
7
Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 407, Taiwan
8
Rong-Hsing Research Center for Translational Medicine and Graduate Institute of Biomedical Sciences, College of Life Science, National Chung Hsing University, Taichung 402, Taiwan
*
Author to whom correspondence should be addressed.
Received: 1 January 2019 / Revised: 4 February 2019 / Accepted: 7 February 2019 / Published: 12 February 2019
(This article belongs to the Section Nephrology & Urology)
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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. View Full-Text
Keywords: NT-proBNP; time-varying; clinical outcomes; hemodialysis; area under the curve (AUC) NT-proBNP; time-varying; clinical outcomes; hemodialysis; area under the curve (AUC)
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Chen, Y.-H.; Fu, Y.-C.; Wu, M.-J. NT-ProBNP Predicts Total Mortality, Emergency Department Visits, Hospitalization, Intensive-Care Unit Admission, and Cardiovascular Events in Hemodialysis Patients. J. Clin. Med. 2019, 8, 238.

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