Which Biomarker is the Best for Predicting Mortality in Incident Peritoneal Dialysis Patients: NT-ProBNP, Cardiac TnT, or hsCRP?

Hyung Jung Oh, Mi Jung Lee, Young Eun Kwon, Kyoung Sook Park, Jung Tak Park, Seung Hyeok Han, Tae Hyun Yoo, Yong Lim Kim, Yon Su Kim, Chul Woo Yang, Nam Ho Kim, Shin Wook Kang

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Abstract

Although numerous previous studies have explored various biomarkers for their ability to predict mortality in end-stage renal disease (ESRD) patients, these studies have been limited by retrospective analyses, mostly prevalent dialysis patients, and the measurement of only 1 or 2 biomarkers. This prospective study was aimed to evaluate the association between 3 biomarkers and mortality in incident 335 ESRD patients starting continuous ambulatory peritoneal dialysis (CAPD) in Korea. According to the baseline NT-proBNP, cTnT, and hsCRP levels, the patients were stratified into tertiles, and cardiovascular (CV) and all-cause mortalities were compared. Additionally, time-dependent ROC curves were constructed, and the net reclassification index (NRI) and integrated discrimination improvement (IDI) of the models with various biomarkers were calculated. We found the upper tertile of NT-proBNP was significantly associated with increased risk of both CV and all-cause mortalities. However, the upper tertile of hsCRP was significantly related only to the high risk of all-cause mortality even after adjustment for age, sex, and white blood cell counts. Moreover, NT-proBNP had the highest predictive power for CV mortality, whereas hsCRP was the best prognostic marker for all-cause mortality among these biomarkers. In conclusions, NT-proBNP is a more significant prognostic factor for CV mortality than cTnT and hsCRP, whereas hsCRP is a more significant predictor than NT-proBNP and cTnT for all-cause mortality in incident peritoneal dialysis patients.

Original languageEnglish
Pages (from-to)e1636
JournalMedicine (United States)
Volume94
Issue number44
DOIs
Publication statusPublished - 2015 Nov 1

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Peritoneal Dialysis
Biomarkers
Mortality
Chronic Kidney Failure
Continuous Ambulatory Peritoneal Dialysis
Korea
Leukocyte Count
ROC Curve
Dialysis
pro-brain natriuretic peptide (1-76)
Prospective Studies

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Oh, Hyung Jung ; Lee, Mi Jung ; Kwon, Young Eun ; Park, Kyoung Sook ; Park, Jung Tak ; Han, Seung Hyeok ; Yoo, Tae Hyun ; Kim, Yong Lim ; Kim, Yon Su ; Yang, Chul Woo ; Kim, Nam Ho ; Kang, Shin Wook. / Which Biomarker is the Best for Predicting Mortality in Incident Peritoneal Dialysis Patients : NT-ProBNP, Cardiac TnT, or hsCRP?. In: Medicine (United States). 2015 ; Vol. 94, No. 44. pp. e1636.
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abstract = "Although numerous previous studies have explored various biomarkers for their ability to predict mortality in end-stage renal disease (ESRD) patients, these studies have been limited by retrospective analyses, mostly prevalent dialysis patients, and the measurement of only 1 or 2 biomarkers. This prospective study was aimed to evaluate the association between 3 biomarkers and mortality in incident 335 ESRD patients starting continuous ambulatory peritoneal dialysis (CAPD) in Korea. According to the baseline NT-proBNP, cTnT, and hsCRP levels, the patients were stratified into tertiles, and cardiovascular (CV) and all-cause mortalities were compared. Additionally, time-dependent ROC curves were constructed, and the net reclassification index (NRI) and integrated discrimination improvement (IDI) of the models with various biomarkers were calculated. We found the upper tertile of NT-proBNP was significantly associated with increased risk of both CV and all-cause mortalities. However, the upper tertile of hsCRP was significantly related only to the high risk of all-cause mortality even after adjustment for age, sex, and white blood cell counts. Moreover, NT-proBNP had the highest predictive power for CV mortality, whereas hsCRP was the best prognostic marker for all-cause mortality among these biomarkers. In conclusions, NT-proBNP is a more significant prognostic factor for CV mortality than cTnT and hsCRP, whereas hsCRP is a more significant predictor than NT-proBNP and cTnT for all-cause mortality in incident peritoneal dialysis patients.",
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Which Biomarker is the Best for Predicting Mortality in Incident Peritoneal Dialysis Patients : NT-ProBNP, Cardiac TnT, or hsCRP? / Oh, Hyung Jung; Lee, Mi Jung; Kwon, Young Eun; Park, Kyoung Sook; Park, Jung Tak; Han, Seung Hyeok; Yoo, Tae Hyun; Kim, Yong Lim; Kim, Yon Su; Yang, Chul Woo; Kim, Nam Ho; Kang, Shin Wook.

In: Medicine (United States), Vol. 94, No. 44, 01.11.2015, p. e1636.

Research output: Contribution to journalArticle

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T1 - Which Biomarker is the Best for Predicting Mortality in Incident Peritoneal Dialysis Patients

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AU - Oh, Hyung Jung

AU - Lee, Mi Jung

AU - Kwon, Young Eun

AU - Park, Kyoung Sook

AU - Park, Jung Tak

AU - Han, Seung Hyeok

AU - Yoo, Tae Hyun

AU - Kim, Yong Lim

AU - Kim, Yon Su

AU - Yang, Chul Woo

AU - Kim, Nam Ho

AU - Kang, Shin Wook

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AB - Although numerous previous studies have explored various biomarkers for their ability to predict mortality in end-stage renal disease (ESRD) patients, these studies have been limited by retrospective analyses, mostly prevalent dialysis patients, and the measurement of only 1 or 2 biomarkers. This prospective study was aimed to evaluate the association between 3 biomarkers and mortality in incident 335 ESRD patients starting continuous ambulatory peritoneal dialysis (CAPD) in Korea. According to the baseline NT-proBNP, cTnT, and hsCRP levels, the patients were stratified into tertiles, and cardiovascular (CV) and all-cause mortalities were compared. Additionally, time-dependent ROC curves were constructed, and the net reclassification index (NRI) and integrated discrimination improvement (IDI) of the models with various biomarkers were calculated. We found the upper tertile of NT-proBNP was significantly associated with increased risk of both CV and all-cause mortalities. However, the upper tertile of hsCRP was significantly related only to the high risk of all-cause mortality even after adjustment for age, sex, and white blood cell counts. Moreover, NT-proBNP had the highest predictive power for CV mortality, whereas hsCRP was the best prognostic marker for all-cause mortality among these biomarkers. In conclusions, NT-proBNP is a more significant prognostic factor for CV mortality than cTnT and hsCRP, whereas hsCRP is a more significant predictor than NT-proBNP and cTnT for all-cause mortality in incident peritoneal dialysis patients.

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