Citation

Teranishi M, Hirata Y, Miyashita K, Suzuki M, Hurudera R, Saitou K, Ishii K, Goto A, Nishiyama K, Matsuoka H. Dokkyo J. Med. Sci. 2008; 35(2): 71-78.

Copyright

(Copyright © 2008, Dokkyo Medical Society)

DOI

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PMID

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Abstract

This study was designed to clarify the clinical significance of post-dialysis plasma vasoactive substances including atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), plasma renin activity (PRA) and noradrenaline (PNA) as a survival predictor in chronic hemo-dialysis (HD) patients. Immediately after HD, blood samples were collected for the measurements of serum albumin, ANP, BNP, PRA and PNA in 52 HD patients. During 15-year follow-up period 43 patients died: 40 of diseases, 2 accident, 1 suicide. Patients were divided into two groups using the median of their age and clinical and laboratory variables. Kaplan - Meier survival analysis revealed that the groups of older age, higher plasma ANP and BNP concentration had significantly lower survival rates as compared with each counterpart (p < 0.001, p = 0.006, p = 0.039, respectively). Univariate and multivariate Cox proportional hazard regression analyses were used to assess the potential association of their age, and clinical and laboratory variables with a survival rate. As a result of Univariate Cox hazard analysis, age, cardiothoracic ratio (CTR), and plasma ANP, and BNP concentrations had significant relationship with overall mortality (p < 0.001, p = 0.011, p = 0.003, and p = 0.002, respectively). However, stepwise multivariate analysis revealed that the significant relationship with overall mortality was shown for their age (p < 0.001) and BNP (p = 0.041). These results demonstrated that the post-dialysis plasma BNP concentration was an independent risk factor for long-term survival and the post-dialysis plasma ANP concentration was also an important risk factor next to the BNP concentration.

Language: ja

Keywords

human; age; prognosis; Survival; survival rate; Hemodialysis; mortality; hemodialysis; kidney failure; survival time; article; controlled study; noradrenalin; follow up; cardiovascular disease; protein blood level; blood analysis; biological marker; anaritide; Atrial natriuretic peptide (ANP); brain natriuretic peptide; Brain natriuretic peptide (BNP); noradrenalin blood level; plasma renin activity