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Erschienen in: Zeitschrift für Gerontologie und Geriatrie 8/2018

Open Access 20.10.2017 | Original contribution

Prognostic value of plasma NT-proBNP levels in very old patients with moderate renal insufficiency in China

verfasst von: Peng Gao, Qiwei Zhu, Suyan Bian, Hongwei Liu, Hongping Xie

Erschienen in: Zeitschrift für Gerontologie und Geriatrie | Ausgabe 8/2018

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Abstract

Background

The N‑terminal pro-brain natriuretic peptide (NT-proBNP) has an important prognostic value in chronic renal insufficiency; however, most studies have been conducted in patients with end-stage renal disease (ESRD). In this study we evaluated the prognostic significance of NT-proBNP in very old patients with stage 3 chronic kidney disease (CKD) and compared its prognostic value in CKD3a versus CKD3b patients.

Methods

Patients (age ≥80 years old) hospitalized with stage 3 CKD from 2007 to 2010 who were eligible for this prospective study underwent follow-up examinations in 2015. The examinations included measurements of anthropometric characteristics, blood pressure, plasma NT-proBNP, creatinine, and lipids. End-point events were all-cause death and major adverse cardiac events (MACEs).

Results

A total of 168 patients (mean age 87.4 ± 2.9 years, range 80–99 years) were included in the analysis (CKD3a, n = 117; CKD3b, n = 51). The results showed that CKD3b was associated with lower hemoglobin levels, higher NT-proBNP levels and a higher rate of hypertension compared with CKD3a. After a median follow-up of 3.8 years (interquartile range 1.5–6.1 years), a higher NT-proBNP level was associated with a higher risk of all-cause death (hazard ratio HR 1.986, 95% confidence interval CI 1.276–2.819, p = 0.028) and MACEs (HR 2.872, 95% CI 1.241–6.644, p = 0.014) after adjusting for age, sex, and traditional risk factors; however, a subgroup comparison showed that elevated NT-proBNP levels were associated with a higher risk of all-cause death (HR 2.350, 95% CI 1.906–6.091, p = 0.039) and MACEs (HR 3.025, 95% CI 1.024–8.940, p = 0.045) in CKD3a but not CKD3b.

Conclusion

Levels of NT-proBNP increased with decreased renal function in very old patients with stage 3 CKD; therefore, NT-proBNP is an independent predictor for all-cause death and MACEs in these patients but has a greater prognostic value in CKD3a than in CKD3b.
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Metadaten
Titel
Prognostic value of plasma NT-proBNP levels in very old patients with moderate renal insufficiency in China
verfasst von
Peng Gao
Qiwei Zhu
Suyan Bian
Hongwei Liu
Hongping Xie
Publikationsdatum
20.10.2017
Verlag
Springer Medizin
Erschienen in
Zeitschrift für Gerontologie und Geriatrie / Ausgabe 8/2018
Print ISSN: 0948-6704
Elektronische ISSN: 1435-1269
DOI
https://doi.org/10.1007/s00391-017-1327-y

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