NT-proBNP level in stage 3-4 chronic kidney disease and mortality in long-term follow-up: HAPPY study subgroup analysis [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2020; 48(5): 454-460 | DOI: 10.5543/tkda.2020.57746

NT-proBNP level in stage 3-4 chronic kidney disease and mortality in long-term follow-up: HAPPY study subgroup analysis

Mustafa Aytek Şimşek1, Muzaffer Değertekin1, Ayça Türer Cabbar1, Burak Hünük1, Serkan Aktürk2, Siyar Erdoğmuş3, Bülent Mutlu4, Ömer Kozan5
1Department of Cardiology, Yeditepe University Faculty of Medicine, İstanbul, Turkey
2Department of Nephrology, Ankara City Hospital, Ankara, Turkey
3Department of Nephrology, Van Training and Research Hospital, Van, Turkey
4Department of Cardiology, Marmara University Faculty of Medicine, İstanbul, Turkey
5Department of Cardiology, Başkent University Faculty of Medicine, İstanbul, Turkey


OBJECTIVE
This was an investigation of the relationship between the N-terminal pro-brain natriuretic peptide (NT-proBNP) level and mortality in patients with stage 3-4 chronic kidney disease (CKD).

METHODS
This study was designed as a subgroup analysis of the Heart Failure Prevalence and Predictors in Turkey (HAPPY) study. The HAPPY study included 4650 randomly selected individuals from the 7 geographical regions of Turkey. A total of 191 subjects from the original cohort with an estimated glomerular filtration rate (eGFR) <60 mL/min/1.1.73 m² were enrolled in this study and the relationship between NT-proBNP and mortality was investigated. Prognostic variables for total and cardiovascular mortality were also examined using Cox regression analysis.

RESULTS
The mean length of follow-up was 76.12±22.45 months. The mean NT-proBNP level was 423.54±955.88 pg/mL. During follow-up, 51 subjects (26.7%) died from any cause and 36 subjects (18.8%) died from a cardiovascular cause. The presence of hypertension (hazard ratio [HR]: 1.89; 95% confidence interval [CI]: 1.01–3.50; p=0.048), 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. The 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.

CONCLUSION
NT-proBNP was found to be an independent prognostic marker in patients with stage 3–4 CKD.

Keywords: Chronic kidney disease, mortality; N-terminal pro-brain natriuretic peptide.

How to cite this article
Mustafa Aytek Şimşek, Muzaffer Değertekin, Ayça Türer Cabbar, Burak Hünük, Serkan Aktürk, Siyar Erdoğmuş, Bülent Mutlu, Ömer Kozan. NT-proBNP level in stage 3-4 chronic kidney disease and mortality in long-term follow-up: HAPPY study subgroup analysis. Turk Kardiyol Dern Ars. 2020; 48(5): 454-460

Corresponding Author: Muzaffer Değertekin, Türkiye
© Copyright 2020 Archives of the Turkish Society of Cardiology
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