Publication

B-type natriuretic peptide and interdialytic fluid retention are independent and incremental predictors of mortality in hemodialysis patients

Westenbrink, B. D., Kremer Hovinga, T., Kloppenburg, W., Veeger, N. J. & Janssen, W., Nov-2011, In : CLINICAL NEPHROLOGY. 76, 5, p. 373-379 7 p.

Research output: Contribution to journalArticleAcademicpeer-review

APA

Westenbrink, B. D., Kremer Hovinga, T., Kloppenburg, W., Veeger, N. J., & Janssen, W. (2011). B-type natriuretic peptide and interdialytic fluid retention are independent and incremental predictors of mortality in hemodialysis patients. CLINICAL NEPHROLOGY, 76(5), 373-379. https://doi.org/10.5414/CN106858

Author

Westenbrink, B. D. ; Kremer Hovinga, T ; Kloppenburg, Wybe ; Veeger, N. J. ; Janssen, Wilbert. / B-type natriuretic peptide and interdialytic fluid retention are independent and incremental predictors of mortality in hemodialysis patients. In: CLINICAL NEPHROLOGY. 2011 ; Vol. 76, No. 5. pp. 373-379.

Harvard

Westenbrink, BD, Kremer Hovinga, T, Kloppenburg, W, Veeger, NJ & Janssen, W 2011, 'B-type natriuretic peptide and interdialytic fluid retention are independent and incremental predictors of mortality in hemodialysis patients', CLINICAL NEPHROLOGY, vol. 76, no. 5, pp. 373-379. https://doi.org/10.5414/CN106858

Standard

B-type natriuretic peptide and interdialytic fluid retention are independent and incremental predictors of mortality in hemodialysis patients. / Westenbrink, B. D.; Kremer Hovinga, T; Kloppenburg, Wybe; Veeger, N. J.; Janssen, Wilbert.

In: CLINICAL NEPHROLOGY, Vol. 76, No. 5, 11.2011, p. 373-379.

Research output: Contribution to journalArticleAcademicpeer-review

Vancouver

Westenbrink BD, Kremer Hovinga T, Kloppenburg W, Veeger NJ, Janssen W. B-type natriuretic peptide and interdialytic fluid retention are independent and incremental predictors of mortality in hemodialysis patients. CLINICAL NEPHROLOGY. 2011 Nov;76(5):373-379. https://doi.org/10.5414/CN106858


BibTeX

@article{abe564b6b38f4d81a31d322c581bf41a,
title = "B-type natriuretic peptide and interdialytic fluid retention are independent and incremental predictors of mortality in hemodialysis patients",
abstract = "Aim: Management of fluid homeostasis remains a major challenge in hemodialysis patients. We aimed to establish whether the cardiac strain marker B-type natriuretic peptide (BNP) could help to identify hypervolemic patients at increased risk of death. Methods: BNP levels were determined before dialysis in the entire I-ID population at our institution (n = 57). IDWG and BNP were stratified above or below 1.5 kg or the median value, respectively. All patients were prospectively followed for 35 months. The influence of IDWG and BNP on mortality was assessed with a Cox proportional hazards model, adjusted for each other, as well as for demographics, comorbidities, cardiac function, residual diuresis, dialysis duration and efficiency and complications of renal failure. Results: Median BNP was 303 (135 - 692) and 21(36%) patients displayed an average IDWG below 1.5 kg. During follow up a total of 25 (44%) patients died, 5 (26%) in the low IDWG group and 20 (53%) in the high IDWG group (adjusted hazard ratio (adjusted HR) 5.31 95% CI (1.47 - 19.1), p = 0.011). In the low BNP group 7 (25%) patients died and in the high BNP Group 18 (62%) patients died (adjusted HR 3.53 95 CI (1.37 - 9.09), p = 0.009). When both factors were considered simultaneously, patients with low BNP and low IDWG had an 11 times lower risk of death compared to patients with high BNP and high IDWG (HR. 0.08 95% CI (0.01 - 0.6129, p = 0.015). Conclusions: BNP and IDWG are independent and incremental predictors of mortality in HD patients. These findings suggest that BNP guided fluid management could improve survival in these patients.",
keywords = "dialysis, BNP, fluid retention, mortality, STAGE RENAL-DISEASE, HEART-FAILURE, DRY-WEIGHT, DIALYSIS PATIENTS, VOLUME",
author = "Westenbrink, {B. D.} and {Kremer Hovinga}, T and Wybe Kloppenburg and Veeger, {N. J.} and Wilbert Janssen",
year = "2011",
month = nov,
doi = "10.5414/CN106858",
language = "English",
volume = "76",
pages = "373--379",
journal = "CLINICAL NEPHROLOGY",
issn = "0301-0430",
publisher = "DUSTRI-VERLAG DR KARL FEISTLE",
number = "5",

}

RIS

TY - JOUR

T1 - B-type natriuretic peptide and interdialytic fluid retention are independent and incremental predictors of mortality in hemodialysis patients

AU - Westenbrink, B. D.

AU - Kremer Hovinga, T

AU - Kloppenburg, Wybe

AU - Veeger, N. J.

AU - Janssen, Wilbert

PY - 2011/11

Y1 - 2011/11

N2 - Aim: Management of fluid homeostasis remains a major challenge in hemodialysis patients. We aimed to establish whether the cardiac strain marker B-type natriuretic peptide (BNP) could help to identify hypervolemic patients at increased risk of death. Methods: BNP levels were determined before dialysis in the entire I-ID population at our institution (n = 57). IDWG and BNP were stratified above or below 1.5 kg or the median value, respectively. All patients were prospectively followed for 35 months. The influence of IDWG and BNP on mortality was assessed with a Cox proportional hazards model, adjusted for each other, as well as for demographics, comorbidities, cardiac function, residual diuresis, dialysis duration and efficiency and complications of renal failure. Results: Median BNP was 303 (135 - 692) and 21(36%) patients displayed an average IDWG below 1.5 kg. During follow up a total of 25 (44%) patients died, 5 (26%) in the low IDWG group and 20 (53%) in the high IDWG group (adjusted hazard ratio (adjusted HR) 5.31 95% CI (1.47 - 19.1), p = 0.011). In the low BNP group 7 (25%) patients died and in the high BNP Group 18 (62%) patients died (adjusted HR 3.53 95 CI (1.37 - 9.09), p = 0.009). When both factors were considered simultaneously, patients with low BNP and low IDWG had an 11 times lower risk of death compared to patients with high BNP and high IDWG (HR. 0.08 95% CI (0.01 - 0.6129, p = 0.015). Conclusions: BNP and IDWG are independent and incremental predictors of mortality in HD patients. These findings suggest that BNP guided fluid management could improve survival in these patients.

AB - Aim: Management of fluid homeostasis remains a major challenge in hemodialysis patients. We aimed to establish whether the cardiac strain marker B-type natriuretic peptide (BNP) could help to identify hypervolemic patients at increased risk of death. Methods: BNP levels were determined before dialysis in the entire I-ID population at our institution (n = 57). IDWG and BNP were stratified above or below 1.5 kg or the median value, respectively. All patients were prospectively followed for 35 months. The influence of IDWG and BNP on mortality was assessed with a Cox proportional hazards model, adjusted for each other, as well as for demographics, comorbidities, cardiac function, residual diuresis, dialysis duration and efficiency and complications of renal failure. Results: Median BNP was 303 (135 - 692) and 21(36%) patients displayed an average IDWG below 1.5 kg. During follow up a total of 25 (44%) patients died, 5 (26%) in the low IDWG group and 20 (53%) in the high IDWG group (adjusted hazard ratio (adjusted HR) 5.31 95% CI (1.47 - 19.1), p = 0.011). In the low BNP group 7 (25%) patients died and in the high BNP Group 18 (62%) patients died (adjusted HR 3.53 95 CI (1.37 - 9.09), p = 0.009). When both factors were considered simultaneously, patients with low BNP and low IDWG had an 11 times lower risk of death compared to patients with high BNP and high IDWG (HR. 0.08 95% CI (0.01 - 0.6129, p = 0.015). Conclusions: BNP and IDWG are independent and incremental predictors of mortality in HD patients. These findings suggest that BNP guided fluid management could improve survival in these patients.

KW - dialysis

KW - BNP

KW - fluid retention

KW - mortality

KW - STAGE RENAL-DISEASE

KW - HEART-FAILURE

KW - DRY-WEIGHT

KW - DIALYSIS PATIENTS

KW - VOLUME

U2 - 10.5414/CN106858

DO - 10.5414/CN106858

M3 - Article

VL - 76

SP - 373

EP - 379

JO - CLINICAL NEPHROLOGY

JF - CLINICAL NEPHROLOGY

SN - 0301-0430

IS - 5

ER -

ID: 5455681