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Mid-regional pro-atrial natriuretic peptide levels before and after hemodialysis predict long-term prognosis

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Hasselbalch, Rasmus Bo ; Kristensen, Jonas Henrik ; Nielsen, Ture Lange ; Plesner, Louis Lind ; Rydahl, Casper ; Schou, Morten ; Goetze, Jens P. ; Bundgaard, Henning ; Iversen, Kasper Karmark. / Mid-regional pro-atrial natriuretic peptide levels before and after hemodialysis predict long-term prognosis. I: Clinical Biochemistry. 2021 ; Bind 94. s. 20-26.

Bibtex

@article{2e73e71521a446abb0403911fef4dde1,
title = "Mid-regional pro-atrial natriuretic peptide levels before and after hemodialysis predict long-term prognosis",
abstract = "Background: Mid-regional pro-atrial natriuretic peptide (MR-proANP) is a strong prognostic biomarker in cardiovascular disease but there is limited data for its use among patients undergoing dialysis. Methods: This was a cohort study of patients receiving maintenance hemodialysis from two Danish centers. Blood sampling and echocardiography were performed before and after a dialysis session. We calculated the area under the curve (AUC) for the receiver operating characteristics for diagnosing heart failure and Cox regressions for cardiovascular events and all-cause mortality. Results: Of the 306 patients, 284 (93%) had MR-proANP measurements both before and after dialysis. Median concentration was 642 pmol/L (IQR 419–858) before and 351 pmol/L (IQR 197–537) after dialysis, a mean decrease of 330 pmol/L (43%, CI 296–364, P < 0.001). MR-proANP concentration both before and after dialysis was negatively correlated to left ventricular ejection fraction with no difference in predictive ability for heart failure, AUC before and after dialysis were 0.60 (CI 0.50–0.70) and 0.61 (CI 0.51–0.71) (P = 0.40). Median follow-up was 32 months (IQR 31–33), during which 99 patients (32%) had a cardiovascular event and 110 (36%) died. A doubling of MR-proANP concentration was associated with a hazard ratio (HR) of 1.6 (CI 1.3–1.9) before and 1.7 (CI 1.4–2.0) after dialysis for mortality and a HR of 1.5 (CI 1.2–1.9) before and 1.4 (CI 1.2–1.7) after dialysis for cardiovascular events (all P < 0.001). Conclusion: The MR-proANP concentration is elevated among patients undergoing hemodialysis and decreases during dialysis. MR-proANP concentration both before, after and intra-dialysis change strongly predicted cardiovascular events and all-cause mortality.",
keywords = "Biomarkers, Dialysis, Echocardiography, Heart failure, Mr-ProANP, Natriuretic peptides, Prognosis, Heart Failure/metabolism, Humans, Natriuretic Peptide, Brain/metabolism, Proportional Hazards Models, Atrial Natriuretic Factor/metabolism",
author = "Hasselbalch, {Rasmus Bo} and Kristensen, {Jonas Henrik} and Nielsen, {Ture Lange} and Plesner, {Louis Lind} and Casper Rydahl and Morten Schou and Goetze, {Jens P.} and Henning Bundgaard and Iversen, {Kasper Karmark}",
note = "Publisher Copyright: {\textcopyright} 2021 The Canadian Society of Clinical Chemists Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",
year = "2021",
month = aug,
day = "1",
doi = "10.1016/j.clinbiochem.2021.04.010",
language = "English",
volume = "94",
pages = "20--26",
journal = "Clinical Biochemistry",
issn = "0009-9120",
publisher = "Elsevier Inc",

}

RIS

TY - JOUR

T1 - Mid-regional pro-atrial natriuretic peptide levels before and after hemodialysis predict long-term prognosis

AU - Hasselbalch, Rasmus Bo

AU - Kristensen, Jonas Henrik

AU - Nielsen, Ture Lange

AU - Plesner, Louis Lind

AU - Rydahl, Casper

AU - Schou, Morten

AU - Goetze, Jens P.

AU - Bundgaard, Henning

AU - Iversen, Kasper Karmark

N1 - Publisher Copyright: © 2021 The Canadian Society of Clinical Chemists Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/8/1

Y1 - 2021/8/1

N2 - Background: Mid-regional pro-atrial natriuretic peptide (MR-proANP) is a strong prognostic biomarker in cardiovascular disease but there is limited data for its use among patients undergoing dialysis. Methods: This was a cohort study of patients receiving maintenance hemodialysis from two Danish centers. Blood sampling and echocardiography were performed before and after a dialysis session. We calculated the area under the curve (AUC) for the receiver operating characteristics for diagnosing heart failure and Cox regressions for cardiovascular events and all-cause mortality. Results: Of the 306 patients, 284 (93%) had MR-proANP measurements both before and after dialysis. Median concentration was 642 pmol/L (IQR 419–858) before and 351 pmol/L (IQR 197–537) after dialysis, a mean decrease of 330 pmol/L (43%, CI 296–364, P < 0.001). MR-proANP concentration both before and after dialysis was negatively correlated to left ventricular ejection fraction with no difference in predictive ability for heart failure, AUC before and after dialysis were 0.60 (CI 0.50–0.70) and 0.61 (CI 0.51–0.71) (P = 0.40). Median follow-up was 32 months (IQR 31–33), during which 99 patients (32%) had a cardiovascular event and 110 (36%) died. A doubling of MR-proANP concentration was associated with a hazard ratio (HR) of 1.6 (CI 1.3–1.9) before and 1.7 (CI 1.4–2.0) after dialysis for mortality and a HR of 1.5 (CI 1.2–1.9) before and 1.4 (CI 1.2–1.7) after dialysis for cardiovascular events (all P < 0.001). Conclusion: The MR-proANP concentration is elevated among patients undergoing hemodialysis and decreases during dialysis. MR-proANP concentration both before, after and intra-dialysis change strongly predicted cardiovascular events and all-cause mortality.

AB - Background: Mid-regional pro-atrial natriuretic peptide (MR-proANP) is a strong prognostic biomarker in cardiovascular disease but there is limited data for its use among patients undergoing dialysis. Methods: This was a cohort study of patients receiving maintenance hemodialysis from two Danish centers. Blood sampling and echocardiography were performed before and after a dialysis session. We calculated the area under the curve (AUC) for the receiver operating characteristics for diagnosing heart failure and Cox regressions for cardiovascular events and all-cause mortality. Results: Of the 306 patients, 284 (93%) had MR-proANP measurements both before and after dialysis. Median concentration was 642 pmol/L (IQR 419–858) before and 351 pmol/L (IQR 197–537) after dialysis, a mean decrease of 330 pmol/L (43%, CI 296–364, P < 0.001). MR-proANP concentration both before and after dialysis was negatively correlated to left ventricular ejection fraction with no difference in predictive ability for heart failure, AUC before and after dialysis were 0.60 (CI 0.50–0.70) and 0.61 (CI 0.51–0.71) (P = 0.40). Median follow-up was 32 months (IQR 31–33), during which 99 patients (32%) had a cardiovascular event and 110 (36%) died. A doubling of MR-proANP concentration was associated with a hazard ratio (HR) of 1.6 (CI 1.3–1.9) before and 1.7 (CI 1.4–2.0) after dialysis for mortality and a HR of 1.5 (CI 1.2–1.9) before and 1.4 (CI 1.2–1.7) after dialysis for cardiovascular events (all P < 0.001). Conclusion: The MR-proANP concentration is elevated among patients undergoing hemodialysis and decreases during dialysis. MR-proANP concentration both before, after and intra-dialysis change strongly predicted cardiovascular events and all-cause mortality.

KW - Biomarkers

KW - Dialysis

KW - Echocardiography

KW - Heart failure

KW - Mr-ProANP

KW - Natriuretic peptides

KW - Prognosis

KW - Heart Failure/metabolism

KW - Humans

KW - Natriuretic Peptide, Brain/metabolism

KW - Proportional Hazards Models

KW - Atrial Natriuretic Factor/metabolism

UR - http://www.scopus.com/inward/record.url?scp=85106223557&partnerID=8YFLogxK

U2 - 10.1016/j.clinbiochem.2021.04.010

DO - 10.1016/j.clinbiochem.2021.04.010

M3 - Journal article

C2 - 33865815

AN - SCOPUS:85106223557

VL - 94

SP - 20

EP - 26

JO - Clinical Biochemistry

JF - Clinical Biochemistry

SN - 0009-9120

ER -

ID: 66083968