B-Type Natriuretic Peptide and Prognosis of End-Stage Renal Disease: A Meta-Analysis

• Published in: PloS one Vol. 8; no. 11; p. e79302
• Main Authors: Cheng, Yun-Jiu, Yao, Feng-Juan, Liu, Li-Juan, Tang, Kai, Lin, Xiao-Xiong, Li, Wei-Jie, Zhang, Jing, Wu, Su-Hua
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 13.11.2013; Public Library of Science (PLoS)
• Subjects: Analysis; Brain natriuretic peptide; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - complications; Cardiovascular Diseases - metabolism; Cardiovascular Diseases - mortality; Cause of Death; Chronic kidney failure; End-stage renal disease; Female; Health aspects; Health risk assessment; Humans; Kidney diseases; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - metabolism; Kidney Failure, Chronic - mortality; Likelihood ratio; Male; Medical ethics; Medical prognosis; Meta-analysis; Mortality; Natriuretic Peptide, Brain - metabolism; Natriuretic peptides; Odds Ratio; Patients; Plasma; Prognosis; Studies; China
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0079302

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. 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. 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.