B type natriuretic peptide and troponin T as independent predictors of cardiovascular mortality in predialysis patients with chronic kidney disease

AbstractCardiovascular disease (CVD) is the leading cause of death in patients with chronic kidney disease (CKD). Osteoprotegerin (OPG), known to regulate bone mass by inhibiting osteoclast differentiation and activation, might also play a role in vascular calcification. Increased circulating OPG levels in patients with CKD are associated with aortic calcification and increased mortality. We assessed the predictive role of OPG for all-cause and cardiovascular mortality in patients with CKD stages 3–5 over a 5-year follow-up period. We evaluated the relationship between OPG and all-cause and cardiovascular mortality in 145 CKD patients (stages 3–5) in a prospective observational follow-up study. Inflammation markers, including high-sensitivity C-reactive protein, standard echocardiography, and estimation of intima-media thickness in the common carotid artery, were assessed at baseline, and correlations with OPG levels were determined. The cutoff values for OPG were defined using ROC curves for cardiovascular mortality. Survival was assessed during follow up lasting for up to 5.5 years using Fine and Gray model. A total of 145 (89 men; age 58.9 ± 15.0 years) were followed up. The cutoff value for OPG determined using ROC was 10 pmol/L for general causes mortality and 10.08 pmol/L for CV causes mortality. Patients with higher serum OPG levels presented with higher mortality rates compared to patients with lower levels. Aalen–Johansen cumulative incidence curve analysis demonstrated significantly worse survival rates in individuals with higher baseline OPG levels for all-cause and cardiovascular mortality (p < 0.001). In multivariate analysis, OPG was a marker of general and cardiovascular mortality independent of sex, age, CVD, diabetes, and CRP levels. When CKD stages were included in the multivariate analysis, OPG was an independent marker of all-cause mortality but not cardiovascular mortality. Elevated serum OPG levels were associated with higher all-cause and cardiovascular mortality risk, independent of age, CVD, diabetes, and inflammatory markers, in patients with CKD.

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Increased circulating bioactive C-type natriuretic peptide is associated with reduced heart rate variability in patients with chronic kidney disease

BMC Nephrology ◽

10.1186/s12882-018-0843-3 ◽

2018 ◽

Vol 19 (1) ◽

Cited By ~ 3

Author(s):

Lulu Wang ◽

Wenjin Liu ◽

Yanting Yu ◽

Lei Jiang ◽

Junwei Yang

Keyword(s):

Chronic Kidney Disease ◽

Heart Rate ◽

Heart Rate Variability ◽

Kidney Disease ◽

Natriuretic Peptide

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Increased Proteinuria is Associated with Increased Aortic Arch Calcification, Cardio-Thoracic Ratio, Rapid Renal Progression and Increased Overall and Cardiovascular Mortality in Chronic Kidney Disease

International Journal of Medical Sciences ◽

10.7150/ijms.45470 ◽

2020 ◽

Vol 17 (8) ◽

pp. 1102-1111 ◽

Cited By ~ 1

Author(s):

Wei-Yu Su ◽

Pei-Yu Wu ◽

Jiun-Chi Huang ◽

Szu-Chia Chen ◽

Jer-Ming Chang

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Aortic Arch ◽

Cardiovascular Mortality ◽

Renal Progression ◽

Aortic Arch Calcification

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Significance of B-Type Natriuretic Peptide Measurement in Patients With Chronic Kidney Disease

Circulation Journal ◽

10.1253/circj.cj-10-0130 ◽

2010 ◽

Vol 74 (4) ◽

pp. 632-633

Author(s):

Yasunobu Hirata

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Natriuretic Peptide

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Left Ventricular Mass Regression, All-Cause and Cardiovascular Mortality in Chronic Kidney Disease: A Meta-Analysis

10.21203/rs.3.rs-699938/v1 ◽

2021 ◽

Author(s):

Kevin C. Maki ◽

Meredith L. Wilcox ◽

Mary R. Dicklin ◽

Rahul Kakkar ◽

Michael H. Davidson

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Left Ventricular Mass ◽

Cardiovascular Mortality ◽

Meta Analysis ◽

Left Ventricular ◽

Secondary Outcome ◽

Ventricular Mass ◽

Increased Risk ◽

All Cause Mortality

Abstract Background Cardiovascular disease is an important driver of the increased mortality associated with chronic kidney disease (CKD). Higher left ventricular mass (LVM) predicts increased risk of adverse cardiovascular outcomes and total mortality, but previous reviews have shown no clear association between intervention-induced LVM change and all-cause or cardiovascular mortality in CKD. Methods The primary objective of this meta-analysis was to investigate whether treatment-induced reductions in LVM over periods ≥ 12 months were associated with all-cause mortality in patients with CKD. Cardiovascular mortality was investigated as a secondary outcome. Measures of association in the form of relative risks (RRs) with associated variability and precision (95% confidence intervals [CIs]) were extracted directly from each study, when reported, or were calculated based on the published data, if possible, and pooled RR estimates were determined. Results The meta-analysis included 38 trials with duration ≥ 12 months: 6 of erythropoietin stimulating agents treating to higher vs. lower hemoglobin targets, 10 of renin-angiotensin-aldosterone system inhibitors vs. placebo or another blood pressure lowering agent, 14 of modified hemodialysis regimens, and 8 of other types of interventions. All-cause mortality was reported in 116/2385 (4.86%) subjects in intervention groups and 161/2404 (6.70%) subjects in control groups. The pooled RR estimate of the 24 trials ≥ 12 months with ≥ 1 event in ≥ 1 group was 0.72 (95% CI 0.57 to 0.91, p = 0.005), with little heterogeneity across studies. Directionalities of the associations in intervention subgroups were the same. Sensitivity analyses of ≥ 6 months (31 trials), ≥ 9 months (26 trials), and > 12 months (9 trials), and including studies with no events in either group, demonstrated similar risk reductions to the primary analysis. The point estimate for cardiovascular mortality was similar to all-cause mortality, but not statistically significant: RR 0.66, 95% CI 0.38 to 1.15. Conclusions These results suggest that LVM regression may be a useful surrogate marker for benefits of interventions intended to reduce mortality risk in patients with CKD.

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