Brain natriuretic peptide and all-cause mortality in patients treated with haemodialysis

Abstract Background Brain natriuretic peptide (BNP) is a hormone secreted from the heart in response to fluid overload. In patients with chronic kidney disease (CKD), inadequate fluid management during haemodialysis may cause fluid overload and overhydration (OH), risk factors for mortality. The aim...

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Main Authors: Maria K Svensson, Rita Nassar, Jan Melin, Magnus Lindberg, Hans Furuland, Jenny Stenberg
Format: Article
Language:English
Published: BMC 2025-06-01
Series:BMC Nephrology
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Online Access:https://doi.org/10.1186/s12882-025-04251-8
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author Maria K Svensson
Rita Nassar
Jan Melin
Magnus Lindberg
Hans Furuland
Jenny Stenberg
author_facet Maria K Svensson
Rita Nassar
Jan Melin
Magnus Lindberg
Hans Furuland
Jenny Stenberg
author_sort Maria K Svensson
collection DOAJ
description Abstract Background Brain natriuretic peptide (BNP) is a hormone secreted from the heart in response to fluid overload. In patients with chronic kidney disease (CKD), inadequate fluid management during haemodialysis may cause fluid overload and overhydration (OH), risk factors for mortality. The aim of this exploratory pilot study was to analyse the relationships between BNP, OH and all-cause mortality in patients with CKD and haemodialysis. Methods In this prospective observational study, five-year survival was analysed in 64 patients with CKD and haemodialysis. Bivariate correlations were performed to analyse the relationships between BNP, OH, and all-cause mortality. Cox regression analysis was performed to adjust the relationship between BNP and all-cause mortality for selected clinical and biochemical characteristics, collected at baseline. Results By the end of the study, 33 patients (52%) had died. In bivariate correlation analysis age (r = 0.38), BNP (r = 0.48), handgrip strength (r=-0.34), lean tissue index (r=-0.41) and CRP level (r=-0.34, p = 0.007) were significantly associated with all-cause mortality. In a linear regression model, BNP was found to be a significant predictor of all-cause mortality (HR 2.61). However, after adjusting for age, handgrip strength, and CRP, BNP was no longer a statistically significant predictor of all-cause mortality. Instead, age, handgrip strength and CRP were significant predictors of all-cause mortality (HR 1.04; HR 0.95 and HR 2.61, respectively). Conclusions In this study, BNP was correlated with all-cause mortality in patients with CKD and haemodialysis, but OH was not. When adjusting for other clinical and biochemical factors, age, inflammation, and handgrip strength were found to be independent and more important predictors of all-cause mortality than BNP.
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spelling doaj-art-e7ca0fe6d8d0462d8d818a7cb8b743572025-08-20T03:27:09ZengBMCBMC Nephrology1471-23692025-06-0126111010.1186/s12882-025-04251-8Brain natriuretic peptide and all-cause mortality in patients treated with haemodialysisMaria K Svensson0Rita Nassar1Jan Melin2Magnus Lindberg3Hans Furuland4Jenny Stenberg5Department of Medical Sciences, Renal Medicine, Uppsala University HospitalDepartment of Medical Sciences, Renal Medicine, Uppsala University HospitalDepartment of Medical Sciences, Renal Medicine, Uppsala University HospitalFaculty of Health and Occupational Studies Department of Caring Sciences, University of GävleDepartment of Medical Sciences, Renal Medicine, Uppsala University HospitalDepartment of Medical Sciences, Renal Medicine, Uppsala University HospitalAbstract Background Brain natriuretic peptide (BNP) is a hormone secreted from the heart in response to fluid overload. In patients with chronic kidney disease (CKD), inadequate fluid management during haemodialysis may cause fluid overload and overhydration (OH), risk factors for mortality. The aim of this exploratory pilot study was to analyse the relationships between BNP, OH and all-cause mortality in patients with CKD and haemodialysis. Methods In this prospective observational study, five-year survival was analysed in 64 patients with CKD and haemodialysis. Bivariate correlations were performed to analyse the relationships between BNP, OH, and all-cause mortality. Cox regression analysis was performed to adjust the relationship between BNP and all-cause mortality for selected clinical and biochemical characteristics, collected at baseline. Results By the end of the study, 33 patients (52%) had died. In bivariate correlation analysis age (r = 0.38), BNP (r = 0.48), handgrip strength (r=-0.34), lean tissue index (r=-0.41) and CRP level (r=-0.34, p = 0.007) were significantly associated with all-cause mortality. In a linear regression model, BNP was found to be a significant predictor of all-cause mortality (HR 2.61). However, after adjusting for age, handgrip strength, and CRP, BNP was no longer a statistically significant predictor of all-cause mortality. Instead, age, handgrip strength and CRP were significant predictors of all-cause mortality (HR 1.04; HR 0.95 and HR 2.61, respectively). Conclusions In this study, BNP was correlated with all-cause mortality in patients with CKD and haemodialysis, but OH was not. When adjusting for other clinical and biochemical factors, age, inflammation, and handgrip strength were found to be independent and more important predictors of all-cause mortality than BNP.https://doi.org/10.1186/s12882-025-04251-8Brain natriuretic peptideFluid overloadHaemodialysisSurvival analysis
spellingShingle Maria K Svensson
Rita Nassar
Jan Melin
Magnus Lindberg
Hans Furuland
Jenny Stenberg
Brain natriuretic peptide and all-cause mortality in patients treated with haemodialysis
BMC Nephrology
Brain natriuretic peptide
Fluid overload
Haemodialysis
Survival analysis
title Brain natriuretic peptide and all-cause mortality in patients treated with haemodialysis
title_full Brain natriuretic peptide and all-cause mortality in patients treated with haemodialysis
title_fullStr Brain natriuretic peptide and all-cause mortality in patients treated with haemodialysis
title_full_unstemmed Brain natriuretic peptide and all-cause mortality in patients treated with haemodialysis
title_short Brain natriuretic peptide and all-cause mortality in patients treated with haemodialysis
title_sort brain natriuretic peptide and all cause mortality in patients treated with haemodialysis
topic Brain natriuretic peptide
Fluid overload
Haemodialysis
Survival analysis
url https://doi.org/10.1186/s12882-025-04251-8
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