title: Predictive value of admission N-terminal pro-B-type natriuretic peptide and renal function in older people hospitalized for dyspnoea.
abstract: BACKGROUND
  We investigated the relationship between NT-pro-BNP, glomerular filtration rate (GFR), and all-cause mortality rates in a cohort of older people discharged from an internal medicine unit after admission for dyspnoea.
  
  
  METHODS
  NT-pro-BNP was evaluated in serum samples of 134 patients aged 80 ± 6 years who presented to a single academic centre with worsening dyspnoea. History data and anthropometric, clinical, and biochemical parameters including GFR were collected at the time of admission. 119 out of 134 were discharged alive from hospital and were included in the follow-up of 779 ± 370 days.
  
  
  RESULTS
  35 out of 119 subjects died after a follow-up of 266 ± 251 days. Cox proportional hazards model showed that GFR and Ln (NT-pro-BNP) were predictors for all-cause mortality with estimated hazard ratios of 0.969 (95% confidence interval: 0.950-0.988; P = 0.001) and 2.360 (95% confidence interval: 1.208-4.610; P = 0.012), respectively. Patients characterized by high NT-pro-BNP levels and GFR ≥ 60 mL/min/1.73 m(2) showed a dramatic reduction in survival duration compared with the groups with different combinations of the two variables (P = 0.008).
  
  
  CONCLUSIONS
  In the elderly, NT-pro-BNP and GFR are predictors of all-cause mortality after admission because of dyspnoea. Since the fact that subjects with high NT-pro-BNP and GFR ≥ 60 mL/min/1.73 m(2) exhibited a reduced survival, high admission NT-pro-BNP suggests future negative outcome.
authors: Department of Medical Sciences, Section of Clinica Medica, Azienda Ospedaliera-Universitaria "S. Anna", Ferrara, Italy.
authors: Fabio
authors: F
authors: Fabbian
authors: Alfredo
authors: A
authors: De Giorgi
authors: Marco
authors: M
authors: Pala
authors: Stefano
authors: S
authors: Volpato
authors: Francesco
authors: F
authors: Portaluppi
authors: Giovanni
authors: G
authors: Zuliani
authors: Roberto
authors: R
authors: Manfredini
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D004417:Dyspnea / Q000097:blood* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D005260:Female; D005919:Glomerular Filtration Rate; D006760:Hospitalization; D006801:Humans; D053208:Kaplan-Meier Estimate; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010343:Patient Admission; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D016016:Proportional Hazards Models
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain