Turk Kardiyol Dern Ars. Ahead of Print: TKDA-57746 | DOI: 10.5543/tkda.2020.57746
NT-proBNP Levels in Stage 3-4 Chronic Kidney Disease and Mortality In Long Term Follow Up: HAPPY study sub group analysis
Mustafa Aytek Şimşek1
, Muzaffer Değertekin1
, Ayça Türer Cabbar1
, Burak Hünük1
, Serkan Aktürk2
, Siyar Erdoğmuş3
, Bülent Mutlu4
, Ömer Kozan51
Department Of Cardiology, Yeditepe University, Istanbul, Turkey2
Department Of Nephrology, Ankara City Hospital, Ankara, Turkey3
Department Of Nephrology, Van Training And Research Hospital, Van, Turkey4
Department Of Cardiology, Marmara University, Istanbul, Turkey5
Department Of Cardiology, Baskent University, Istanbul, Turkey
We aimed to investigate the relationship between N-terminal pro-brain natriuretic peptide (NT-proBNP) levels and mortality in patients with stage 3-4 chronic kidney disease (CKD).
This study was designed as a sub group analysis of Heart Failure Prevalance and Predictors in Turkey (HAPPY) study. HAPPY study included randomly selected 4650 individuals from 7 geographical regions of Turkey. 191 subjects from the original cohort with estimated glomerular filtration rate (eGFR) below 60 ml min -1/1.73 m2 were enrolled in this study. Relationship between NT-proBNP and mortality was investigated. Also prognostic variables for total and cardiovascular mortality was searched using Cox regression analysis.
The mean follow-up was 76.12±22.45 months. The mean NT-proBNP level was 423.54± 955.88 pg/ml. 51 subjects (26.7%) died from any cause and 36 subjects (18.8%) died from a cardiovascular cause during follow up. Presence of hypertension (HR, 1.89; 95% confidence interval [CI] 1.01-3.50; P=0.048), presence of anemia (HR, 2.49; 95% CI 1.20-5.15; P=0.014), male gender (HR, 2.64 95% CI 1.44-4.86; P=0.002) and log NT-proBNP (HR, 4.93; 95% CI 2.83-8.58; P<0.001) were independent variables for total mortality. Presence of hypertension (HR, 2.47; 95% CI 1.09-5.56; P=0.029), male gender (HR, 2.79; 95% CI 1.38-5.62; P=0.004), eGFR (HR, 0.94; 95% CI 0.91-0.98; P=0.005) and log NT-proBNP (HR, 6.31; 95% CI 3.11-12.81; P<0.001) were independent predictors of cardiovascular mortality.
In this study NT-proBNP was found as an independent prognostic marker in patients with stage 3-4 CKD.
Chronic kidney disease, NT-proBNP, Mortality
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Corresponding Author: Muzaffer Değertekin, Türkiye