• Frontiers in medicine · Jan 2020

    Serum N-terminal Pro-B-type Natriuretic Peptide Predicts Mortality in Cardiac Surgery Patients Receiving Renal Replacement Therapy.

    • Ying Su, Jun-Yi Hou, Yi-Jie Zhang, Guo-Guang Ma, Guang-Wei Hao, Jing-Chao Luo, Zhe Luo, and Guo-Wei Tu.
    • Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
    • Front Med (Lausanne). 2020 Jan 1; 7: 153.

    AbstractBackground: N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a useful cardiac biomarker that is associated with acute kidney injury (AKI) and mortality after cardiac surgery. However, its prognostic value in cardiac surgical patients receiving renal replacement therapy (RRT) remains unclear. Objectives: Our study aimed to assess the prognostic value of NT-proBNP in patients with established AKI receiving RRT after cardiac surgery. Methods: A total of 163 cardiac surgical patients with AKI requiring RRT were enrolled in this study. Baseline characteristics, hemodynamic variables at RRT initiation, and NT-proBNP level before surgery, at RRT initiation, and on the first day after RRT were collected. The primary outcome was 28-day mortality after RRT initiation. Results: Serum NT-proBNP levels in non-survivors was markedly higher than survivors before surgery (median: 4,096 [IQR, 962.0-9583.8] vs. 1,339 [IQR, 446-5,173] pg/mL; P < 0.01), at RRT initiation (median: 10,366 [IQR, 5,668-20,646] vs. 3,779 [IQR, 1,799-11,256] pg/mL; P < 0.001), and on the first day after RRT (median: 9,055.0 [IQR, 4,392-24,348] vs. 5,255 [IQR, 2,134-9,175] pg/mL; P < 0.001). The area under the receiver operating characteristic curve of NT-proBNP before surgery, at RRT initiation, and on the first day after RRT for predicting 28-day mortality was 0.64 (95% CI, 0.55-0.73), 0.71 (95% CI, 0.63-0.79), and 0.68 (95% CI, 0.60-0.76), respectively. Consistently, Cox regression revealed that NT-proBNP levels before surgery (HR: 1.27, 95% CI, 1.06-1.52), at RRT initiation (HR: 1.11, 95% CI, 1.06-1.17), and on the first day after RRT (HR: 1.17, 95% CI, 1.11-1.23) were independently associated with 28-day mortality. Conclusions: Serum NT-proBNP was an independent predictor of 28-day mortality in cardiac surgical patients with AKI requiring RRT. The prognostic role of NT-proBNP needs to be confirmed in the future.Copyright © 2020 Su, Hou, Zhang, Ma, Hao, Luo, Luo and Tu.

      Pubmed     Free full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…