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Addition of Novel Biomarkers for Predicting All‐Cause and Cardiovascular Mortality in Prevalent Hemodialysis Patients
Author(s) -
Yamashita Kazuomi,
Mizuiri Sonoo,
Nishizawa Yoshiko,
Shigemoto Kenichiro,
Doi Shigehiro,
Masaki Takao
Publication year - 2018
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/1744-9987.12593
Subject(s) - medicine , hemodialysis , intensive care medicine , cause of death , disease
Novel biomarkers might improve the prediction of mortality in hemodialysis (HD) patients. We simultaneously measured the levels of conventional and novel biomarkers [serum N‐terminal pro‐brain natriuretic peptide (NT‐proBNP), intact fibroblast growth factor‐23 (FGF23), β2‐microglobulin (β2MG), cystatin C, and high‐sensitivity C‐reactive protein (hsCRP)] in 307 prevalent Japanese HD patients. There were 66 all‐cause deaths, and 25 cardiovascular (CV) deaths during 2 years, which were assessed using Cox models and concordance (C)‐statistics. The addition of NT‐proBNP alone ( P < 0.05) or NT‐proBNP, hsCRP, and β2MG as a panel (C‐statistics: 0.834 vs. 0.776, P < 0.01) to a conventional risk model composed of age, diabetes, and the serum albumin level significantly improved the prediction of 2‐year all‐cause mortality, and the addition of NT‐proBNP and hsCRP as a panel to a conventional risk model composed of age significantly improved the prediction of 2‐year CV mortality ( P < 0.05) in Japanese prevalent HD patients. Neither FGF23 nor cystatin C improved mortality prediction.