B-type natriuretic peptide and prognosis of end-stage renal disease: a meta-analysis

PLoS One. 2013 Nov 13;8(11):e79302. doi: 10.1371/journal.pone.0079302. eCollection 2013.

Abstract

Background: The prognostic importance of B-type natriuretic peptide (BNP) or N-terminal pro BNP (NT-proBNP) in patients with end-stage renal disease (ESRD) remains controversial.

Methodology/principal findings: We conducted an unrestricted search from the MEDLINE and EMBASE in all languages that were published between 1966 and Augest2013. Twenty-seven long-term prospective studies met our inclusion criterias. From the pooled analysis, elevated BNP/NT-proBNP was significantly associated with increased all cause mortality [odds ratio (OR), 3.85; 95% CI, 3.11 to 4.75], cardiovascular mortality (OR, 4.05; 95% CI, 2.53 to 6.84), and cardiovascular events (OR, 7.02; 95% CI, 2.21 to 22.33). The funnel plot showed no evidence of publication bias. The corresponding pooled positive and negative likelihood ratio for prediction of all cause mortality were 1.86 (95% CI, 1.66 to 2.08) and 0.48 (95% CI, 0.42 to 0.55), respectively.

Conclusions/significance: BNP/NT-proBNP is a promising prognostic tool to risk-stratify the patients with ESRD. Further investigations are warranted to elucidate the specific pathogenic mechanisms and the impact of other potential prognostic factors.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cardiovascular Diseases / complications
  • Cardiovascular Diseases / metabolism
  • Cardiovascular Diseases / mortality
  • Cause of Death
  • Female
  • Humans
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / metabolism*
  • Kidney Failure, Chronic / mortality
  • Male
  • Natriuretic Peptide, Brain / metabolism*
  • Odds Ratio
  • Prognosis

Substances

  • Natriuretic Peptide, Brain

Grant support

This work was supported by National Natural Science Foundation of China (No. 81370285), Guangdong Province Natural Science Foundation (No. 06021338); Guangdong Province Science and Technology Program (No. 2012B031800091, 2007B031508003) and National Ministry of Education Scholarly Exchanges Foundation (No. 200724). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.