TY - JOUR
T1 - The effect of natriuretic C-type peptide and its change over time on mortality in patients on haemodialysis or haemodiafiltration
AU - de Roij van Zuijdewijn, Camiel L M
AU - van Gastel, Lieke H A
AU - Ter Wee, Piet M
AU - Bots, Michiel L
AU - Blankestijn, Peter J
AU - van den Dorpel, Marinus A
AU - Fouque, Denis
AU - Nubé, Menso J
AU - Grooteman, Muriel P C
N1 - © The Author(s) 2019. Published by Oxford University Press on behalf of ERA-EDTA.
PY - 2021/1/1
Y1 - 2021/1/1
N2 - BACKGROUND: C-type natriuretic peptide (CNP) and its co-product N-terminal proCNP (NTproCNP) have been associated with beneficial effects on the cardiovascular system. In prevalent dialysis patients, however, a relation between NTproCNP and mortality has not yet been investigated. Furthermore, as a middle molecular weight substance, its concentration might be influenced by dialysis modality.METHODS: In a cohort of patients treated with haemodialysis (HD) or haemodiafiltration (HDF), levels of NTproCNP were measured at baseline and 6, 12, 24 and 36 months. The relation between serum NTproCNP and mortality and the relation between the 6-month rate of change of NTproCNP and mortality were analysed using Cox regression models. For the longitudinal analyses, linear mixed models were used.RESULTS: In total, 406 subjects were studied. The median baseline serum NTproCNP was 93 pmol/L and the median follow-up was 2.97 years. No relation between baseline NTproCNP or its rate of change over 6 months and mortality was found. NTproCNP levels remained stable in HD patients, whereas NTproCNP decreased significantly in HDF patients. The relative decline depended on the magnitude of the convection volume.CONCLUSIONS: In our study, levels of NTproCNP appear strongly elevated in prevalent dialysis patients. Second, while NTproCNP remains unaltered in HD patients, its levels decline in individuals treated with HDF, with the decline dependent on the magnitude of the convection volume. Third, NTproCNP is not related to mortality in this population. Thus NTproCNP does not seem to be a useful marker for mortality risk in dialysis patients.
AB - BACKGROUND: C-type natriuretic peptide (CNP) and its co-product N-terminal proCNP (NTproCNP) have been associated with beneficial effects on the cardiovascular system. In prevalent dialysis patients, however, a relation between NTproCNP and mortality has not yet been investigated. Furthermore, as a middle molecular weight substance, its concentration might be influenced by dialysis modality.METHODS: In a cohort of patients treated with haemodialysis (HD) or haemodiafiltration (HDF), levels of NTproCNP were measured at baseline and 6, 12, 24 and 36 months. The relation between serum NTproCNP and mortality and the relation between the 6-month rate of change of NTproCNP and mortality were analysed using Cox regression models. For the longitudinal analyses, linear mixed models were used.RESULTS: In total, 406 subjects were studied. The median baseline serum NTproCNP was 93 pmol/L and the median follow-up was 2.97 years. No relation between baseline NTproCNP or its rate of change over 6 months and mortality was found. NTproCNP levels remained stable in HD patients, whereas NTproCNP decreased significantly in HDF patients. The relative decline depended on the magnitude of the convection volume.CONCLUSIONS: In our study, levels of NTproCNP appear strongly elevated in prevalent dialysis patients. Second, while NTproCNP remains unaltered in HD patients, its levels decline in individuals treated with HDF, with the decline dependent on the magnitude of the convection volume. Third, NTproCNP is not related to mortality in this population. Thus NTproCNP does not seem to be a useful marker for mortality risk in dialysis patients.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85120054733&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/33564441
U2 - https://doi.org/10.1093/ckj/sfz156
DO - https://doi.org/10.1093/ckj/sfz156
M3 - Article
C2 - 33564441
SN - 2048-8505
VL - 14
SP - 375
EP - 381
JO - Clinical Kidney Journal
JF - Clinical Kidney Journal
IS - 1
ER -