The interaction between N-terminal pro-brain natriuretic peptide and fluid status in adverse clinical outcomes of late stages of chronic kidney disease.
INTRODUCTION:Fluid overload is one of the major characteristics and complications in patients with chronic kidney disease (CKD). N-terminal pro-brain natriuretic peptide (NT-proBNP) is related to fluid status and fluid distribution. The aim of this study is to investigate the interaction between NT-...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2018-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC6105012?pdf=render |
| _version_ | 1811214204886056960 |
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| author | Yi-Chun Tsai Hui-Ju Tsai Chee-Siong Lee Yi-Wen Chiu Hung-Tien Kuo Su-Chu Lee Tzu-Hui Chen Mei-Chuan Kuo |
| author_facet | Yi-Chun Tsai Hui-Ju Tsai Chee-Siong Lee Yi-Wen Chiu Hung-Tien Kuo Su-Chu Lee Tzu-Hui Chen Mei-Chuan Kuo |
| author_sort | Yi-Chun Tsai |
| collection | DOAJ |
| description | INTRODUCTION:Fluid overload is one of the major characteristics and complications in patients with chronic kidney disease (CKD). N-terminal pro-brain natriuretic peptide (NT-proBNP) is related to fluid status and fluid distribution. The aim of this study is to investigate the interaction between NT-proBNP and fluid status in adverse clinical outcomes of late stages of CKD. METHODS:We enrolled 239 patients with CKD stages 4-5 from January 2011 to December 2011 and followed up until June 2017. Fluid status was presented as hydration status (HS) value measured by body composition monitor, while HS>7% was defined as fluid overload. Clinical outcomes included renal outcomes (commencing dialysis and estimated glomerular filtration rate decline>3 ml/min/1.73 m2/year), all-cause mortality and major adverse cardiovascular events (MACEs). RESULTS:During a mean follow-up of 3.3±2.0 years, 129(54.7%) patients commenced dialysis, 88(37.3%) patients presented rapid renal function decline, and 48(20.3%) had MACEs or died. All patients were stratified by HS of 7% and the median of plasma NT-proBNP. The adjusted risks for commencing dialysis was significantly higher in patients with high plasma NT-proBNP and HS>7% compared to those with low plasma NT-proBNP and HS≦7%. There was a significant interaction between plasma NT-proBNP and HS in commencing dialysis (P-interaction = 0.047). Besides, patients with high plasma NT-proBNP and HS>7% had greater risks for MACEs or all-cause mortality than others with either high plasma NT-proBNP or HS>7%. CONCLUSION:NT-proBNP and fluid overload might have a synergistic association of adverse clinical outcomes in patients with late stages of CKD. |
| first_indexed | 2024-04-12T05:59:22Z |
| format | Article |
| id | doaj.art-7167d862074d46a1ae443ef7bdbe7d9c |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-12T05:59:22Z |
| publishDate | 2018-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-7167d862074d46a1ae443ef7bdbe7d9c2022-12-22T03:45:05ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-01138e020273310.1371/journal.pone.0202733The interaction between N-terminal pro-brain natriuretic peptide and fluid status in adverse clinical outcomes of late stages of chronic kidney disease.Yi-Chun TsaiHui-Ju TsaiChee-Siong LeeYi-Wen ChiuHung-Tien KuoSu-Chu LeeTzu-Hui ChenMei-Chuan KuoINTRODUCTION:Fluid overload is one of the major characteristics and complications in patients with chronic kidney disease (CKD). N-terminal pro-brain natriuretic peptide (NT-proBNP) is related to fluid status and fluid distribution. The aim of this study is to investigate the interaction between NT-proBNP and fluid status in adverse clinical outcomes of late stages of CKD. METHODS:We enrolled 239 patients with CKD stages 4-5 from January 2011 to December 2011 and followed up until June 2017. Fluid status was presented as hydration status (HS) value measured by body composition monitor, while HS>7% was defined as fluid overload. Clinical outcomes included renal outcomes (commencing dialysis and estimated glomerular filtration rate decline>3 ml/min/1.73 m2/year), all-cause mortality and major adverse cardiovascular events (MACEs). RESULTS:During a mean follow-up of 3.3±2.0 years, 129(54.7%) patients commenced dialysis, 88(37.3%) patients presented rapid renal function decline, and 48(20.3%) had MACEs or died. All patients were stratified by HS of 7% and the median of plasma NT-proBNP. The adjusted risks for commencing dialysis was significantly higher in patients with high plasma NT-proBNP and HS>7% compared to those with low plasma NT-proBNP and HS≦7%. There was a significant interaction between plasma NT-proBNP and HS in commencing dialysis (P-interaction = 0.047). Besides, patients with high plasma NT-proBNP and HS>7% had greater risks for MACEs or all-cause mortality than others with either high plasma NT-proBNP or HS>7%. CONCLUSION:NT-proBNP and fluid overload might have a synergistic association of adverse clinical outcomes in patients with late stages of CKD.http://europepmc.org/articles/PMC6105012?pdf=render |
| spellingShingle | Yi-Chun Tsai Hui-Ju Tsai Chee-Siong Lee Yi-Wen Chiu Hung-Tien Kuo Su-Chu Lee Tzu-Hui Chen Mei-Chuan Kuo The interaction between N-terminal pro-brain natriuretic peptide and fluid status in adverse clinical outcomes of late stages of chronic kidney disease. PLoS ONE |
| title | The interaction between N-terminal pro-brain natriuretic peptide and fluid status in adverse clinical outcomes of late stages of chronic kidney disease. |
| title_full | The interaction between N-terminal pro-brain natriuretic peptide and fluid status in adverse clinical outcomes of late stages of chronic kidney disease. |
| title_fullStr | The interaction between N-terminal pro-brain natriuretic peptide and fluid status in adverse clinical outcomes of late stages of chronic kidney disease. |
| title_full_unstemmed | The interaction between N-terminal pro-brain natriuretic peptide and fluid status in adverse clinical outcomes of late stages of chronic kidney disease. |
| title_short | The interaction between N-terminal pro-brain natriuretic peptide and fluid status in adverse clinical outcomes of late stages of chronic kidney disease. |
| title_sort | interaction between n terminal pro brain natriuretic peptide and fluid status in adverse clinical outcomes of late stages of chronic kidney disease |
| url | http://europepmc.org/articles/PMC6105012?pdf=render |
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