B-type natriuretic peptide and prognosis of end-stage renal disease: a meta-analysis.
BACKGROUND
The prognostic importance of B-type natriuretic peptide (BNP) or N-terminal pro BNP (NT-proBNP) in patients with end-stage renal disease (ESRD) remains controversial.


RESULTS
We conducted an unrestricted search from the MEDLINE and EMBASE in all languages that were published between 1966 and Augest2013. Twenty-seven long-term prospective studies met our inclusion criterias. From the pooled analysis, elevated BNP/NT-proBNP was significantly associated with increased all cause mortality [odds ratio (OR), 3.85; 95% CI, 3.11 to 4.75], cardiovascular mortality (OR, 4.05; 95% CI, 2.53 to 6.84), and cardiovascular events (OR, 7.02; 95% CI, 2.21 to 22.33). The funnel plot showed no evidence of publication bias. The corresponding pooled positive and negative likelihood ratio for prediction of all cause mortality were 1.86 (95% CI, 1.66 to 2.08) and 0.48 (95% CI, 0.42 to 0.55), respectively.


CONCLUSIONS
BNP/NT-proBNP is a promising prognostic tool to risk-stratify the patients with ESRD. Further investigations are warranted to elucidate the specific pathogenic mechanisms and the impact of other potential prognostic factors.
Department of Cardiovascular Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Yun-Jiu
YJ
Cheng
Feng-Juan
FJ
Yao
Li-Juan
LJ
Liu
Kai
K
Tang
Xiao-Xiong
XX
Lin
Wei-Jie
WJ
Li
Jing
J
Zhang
Su-Hua
SH
Wu
D002318:Cardiovascular Diseases / Q000150:complications / Q000378:metabolism / Q000401:mortality; D002423:Cause of Death; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000378:metabolism* / Q000401:mortality; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000378:metabolism*; D016017:Odds Ratio; D011379:Prognosis
D020097:Natriuretic Peptide, Brain