title: Nt-proBNP in haemodialysis patients: a preliminary study.
abstract: OBJECTIVE
  N-terminal pro-brain natriuretic peptide (Nt-proBNP) is a marker of left ventricular function. Although many factors can increase left ventricular dysfunction in haemodialysis patients, the role of Nt-proBNP is uncertain.
  
  
  METHODS
  Serum concentrations of Nt-proBNP and troponin T were measured by electrochemiluminescence and C-reactive protein by immunoturbidimetry in 52 dialysis patients followed-up for 36 months.
  
  
  RESULTS
  Nt-proBNP correlated (p<0.05) with time on haemodialysis (rho=0.345), left ventricular mass index (r=0.596), troponin T level (r=0.605) and age (r=0.296). Patients with a history of heart disease showed higher levels of Nt-proBNP (median; minimum-maximum ngl/L) (15,571; 1,553-209,451) than those without (4,535; 751-115,078) (p<0.01). Sensitivity and specificity of Nt-proBNP in the detection of left ventricular dysfunction (ventricular ejection fraction < 45%) were 1.0 and 0.782, respectively. In the univariate analysis, patients with Nt-proBNP levels > or = 33,314 ng/L, CRP > or = 5 mg/L or troponin T > or = 0.1 microg/L had poorer probabilities of 1-year, 2-year and 3-year survival than patients with lower levels. Unfavourable prognostic factors in the multivariate analysis were CRP > 5 mg/L and Tn T > 0.1 microg/L.
  
  
  CONCLUSIONS
  Nt-proBNP showed good diagnostic performance for detecting left ventricular dysfunction and was an important predictor of mortality in haemodialysis patients in the univariate analysis. In the multivariate analysis, Nt-proBNP lost its prognostic value, whereas for CRP and Tn T it was maintained.
authors.affiliation: Department of Clinical Biochemistry, Hospital Sant Joan de Déu, Althaia Xarxa Assistencial de Manresa, Manresa, Barcelona, Spain. jtrape@yahoo.es
authors.forename: Jaume
authors.initials: J
authors.lastname: Trapé
authors.forename: Alicia
authors.initials: A
authors.lastname: Pérez
authors.forename: Isabel
authors.initials: I
authors.lastname: Naval
authors.forename: Juan
authors.initials: J
authors.lastname: Escudero
authors.forename: Isabel
authors.initials: I
authors.lastname: Comerma
authors.forename: Antonia
authors.initials: A
authors.lastname: Sans
authors.forename: Josefina
authors.initials: J
authors.lastname: Franquesa
authors.forename: Carmen
authors.initials: C
authors.lastname: Vidal
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D006435:Renal Dialysis; D015996:Survival Rate
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain