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      The Predictive Value of NT-Pro-Brain Natriuretic Peptide for Risk of Pneumonia in Patients on Maintenance Hemodialysis

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          Background/Aims: Pneumonia is a common type of infection in maintenance hemodialysis (MHD) patients, while the treatment and prevention progress still keep limited. N-terminal-pro-brain natriuretic peptide (NT-proBNP) is an important marker in reflecting cardiac failure which also is a risk factor for pneumonia. This study aimed to determine the possible predictive value of NT-proBNP for pneumonia in MHD patients. Methods: In this prospective study, the basic information of 276 MHD patients was collected in Fudan university Zhongshan hospital, followed up for 1 year. The primary endpoint was the first pneumonia event during follow-up. The value of NT-proBNP in patients with pneumonia and without pneumonia was analyzed, to elucidate the predictive value of the NT-proBNP in hemodialysis patients with pneumonia. Results: Two hundred and seventy-six patients were finally enrolled in this prospective study, including 170 men. The mean age was 59.7 ± 14.0 years old. The average duration of hemodialysis is 56 (30–82.8) months. Enrolled patients were followed up for 1 year. During follow-up, 38 patients got pneumonia. After adjustment for other confounding factors, age (hazard ratio [HR] 1.031, 95% CI 1.003–1.060, p = 0.028), log NT-proBNP (HR 2.512, 95% CI 1.124–5.612, p = 0.025), history of smoking (HR 6.326, 95% CI 2.505–15.974, p < 0.001), β2-microglobin (HR 1.042, 95% CI 1.007–1.079, p = 0.019), and history of cerebrovascular disease (HR 2.303, 95% CI 1.107–4.719, p = 0.026) were independent predictors of pneumonia. Receiver operating characteristic curves of log NT-proBNP to predict 1 year pneumonia cases, log NT-proBNP had an area under the curve of 0.647 (95% CI [0.564–0.729], p < 0.01). Conclusions: NT-proBNP is a predictive factor of pneumonia in hemodialysis patients.

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          Author and article information

          Blood Purif
          Blood Purification
          S. Karger AG
          May 2020
          24 January 2020
          : 49
          : 3
          : 348-355
          aDepartment of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
          bShanghai Medical Center of Kidney, Shanghai, China
          cShanghai Institute of Kidney and Dialysis, Shanghai, China
          dShanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
          eHemodialysis Quality Control Center of Shanghai, Shanghai, China
          Author notes
          *Dr. Fangfang Xiang and Jianzhou Zou, Department of Nephrology, Zhongshan Hospital, Fudan University, No. 180, Fenglin Road, Xuhui, Shanghai 200032 (China), E-Mail xiang.fangfang@zs-hospital.sh.cn and zou.jianzhou@zs-hospital.sh.cn
          504524 Blood Purif 2020;49:348–355
          © 2020 S. Karger AG, Basel

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          Page count
          Figures: 2, Tables: 3, Pages: 8
          Research Article


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