title: Investigation of optimum N-terminal probrain natriuretic peptide level in patients on maintained hemodialysis.
abstract: Serum N-terminal probrain natriuretic peptide (NT-proBNP) level is known to be strongly associated with fluid overload, and serves as a guide for fluid management in patients on hemodialysis (HD). This study aimed at investigating the relationship between NT-proBNP level and blood pressure (BP), ultrafiltration/dry weight ratio as well as hemoglobin, and to explore the optimal cutoff point of NT-proBNP level in Chinese patients on HD.
  
  
  
  A total of 306 patients on maintained HD for stage 5 chronic kidney disease (CKD) were included in this prospective study [corrected]. Their average ultrafiltration/dry weight ratio and BP before dialysis were recorded. The serum NT-proBNP, hemoglobin, serum calcium, and phosphorus were detected. The cutoff value for NT-proBNP level was calculated using receiver operating characteristic (ROC) analysis.
  
  
  
  The high NT-proBNP level was associated with high BP and ultrafiltration/dry weight ratio, and low hemoglobin level. The optimal cutoff point of NT-proBNP level for patients on maintained HD was 5666 pg/mL, with a sensitivity of 78.5%, specificity of 43.9%, and area under the curve (AUC) of 0.703 (<0.001).
  
  
  
  NT-proBNP level ≤5666 pg/mL was recommended to achieve the target BP, hemoglobin level, and ultrafiltration/dry weight ratio in patients on maintained HD with an ejection fraction (EF) >50%.
authors.affiliation: a Department of Nephrology , Zhongshan Hospital, Xiamen University , Xiamen , Fujian , China.
authors.forename: Lan
authors.initials: L
authors.lastname: Chen
authors.affiliation: a Department of Nephrology , Zhongshan Hospital, Xiamen University , Xiamen , Fujian , China.
authors.forename: Ying-Ying
authors.initials: YY
authors.lastname: Chen
authors.affiliation: a Department of Nephrology , Zhongshan Hospital, Xiamen University , Xiamen , Fujian , China.
authors.forename: Yi-Sheng
authors.initials: YS
authors.lastname: Ling
authors.affiliation: a Department of Nephrology , Zhongshan Hospital, Xiamen University , Xiamen , Fujian , China.
authors.forename: Chun-Hua
authors.initials: CH
authors.lastname: Lin
authors.affiliation: a Department of Nephrology , Zhongshan Hospital, Xiamen University , Xiamen , Fujian , China.
authors.forename: Jin-Xuan
authors.initials: JX
authors.lastname: He
authors.affiliation: a Department of Nephrology , Zhongshan Hospital, Xiamen University , Xiamen , Fujian , China.
authors.forename: Tian-Jun
authors.initials: TJ
authors.lastname: Guan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D002118:Calcium / Q000097:blood; D002681:China; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D010758:Phosphorus / Q000097:blood; D011446:Prospective Studies; D012372:ROC Curve; D006435:Renal Dialysis; D014462:Ultrafiltration; D055815:Young Adult
chemical_list: D006454:Hemoglobins; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D010758:Phosphorus; D002118:Calcium
keywords: Blood pressure; N-terminal probrain natriuretic peptide; dry weight; hemodialysis; hemoglobin