Kidney medicine · 2026
Pre-Dialysis Trajectory of Brain Natriuretic Peptide Levels and Body Weight in Chronic Kidney Disease Patients: A Predictive Marker for Unplanned Dialysis Initiation.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Sugihara Shinnosuke, Nakayama Takashin, Azegami Tatsuhiko, Hayashi Kaori
Аннотация
RATIONALE & OBJECTIVE: Unplanned dialysis initiation in chronic kidney disease (CKD) patients is associated with adverse outcomes, yet reliable predictors for optimal dialysis timing remain elusive. The clinical significance of longitudinal changes in brain natriuretic peptide (BNP) levels and body weight (BW) in this context is unclear. We examined whether these parameters predict the risk of unplanned dialysis.
STUDY DESIGN SETTING & POPULATION: This retrospective cohort study included 231 CKD patients initiating maintenance dialysis between 2014 and 2024 at a single Japanese university hospital.
PREDICTORS & OUTCOMES: Predictors were BNP levels and BW ratios, defined as the 3-month value divided by the average of values obtained 6-12 months before dialysis initiation. The primary outcome was unplanned dialysis initiation.
ANALYTICAL APPROACH: We assessed associations between BNP levels or BW ratio and unplanned dialysis initiation using multivariable logistic regression models.
RESULTS: Among 231 patients included in the analysis, 137 (59%) had planned and 94 (41%) unplanned dialysis initiation. The median (interquartile range) age was 70 (61-79) years, and 67 (29%) were female. BNP levels increased toward dialysis initiation, particularly in the unplanned group, whereas BW remained largely stable in both groups. A high BNP ratio (>median) was significantly associated with an increased likelihood of unplanned dialysis initiation (odds ratio [OR], 5.64; 95% confidence interval [CI], 2.90-10.99). For the BW ratio, both weight loss (<25th percentile; OR, 3.47; 95% CI, 1.58-7.65) and weight gain (>75th percentile; OR, 2.33; 95% CI, 1.11-4.87) were associated with an increased likelihood of unplanned dialysis initiation.
LIMITATIONS: Retrospective, single-center design with possible residual confounding and limited generalizability; unavailability of body composition data.
CONCLUSIONS: In patients with advanced CKD, trajectories of BNP, together with BW, were significant predictors of unplanned dialysis initiation. Close monitoring of these parameters might help identify high-risk patients and facilitate a timely dialysis transition.
STUDY DESIGN SETTING & POPULATION: This retrospective cohort study included 231 CKD patients initiating maintenance dialysis between 2014 and 2024 at a single Japanese university hospital.
PREDICTORS & OUTCOMES: Predictors were BNP levels and BW ratios, defined as the 3-month value divided by the average of values obtained 6-12 months before dialysis initiation. The primary outcome was unplanned dialysis initiation.
ANALYTICAL APPROACH: We assessed associations between BNP levels or BW ratio and unplanned dialysis initiation using multivariable logistic regression models.
RESULTS: Among 231 patients included in the analysis, 137 (59%) had planned and 94 (41%) unplanned dialysis initiation. The median (interquartile range) age was 70 (61-79) years, and 67 (29%) were female. BNP levels increased toward dialysis initiation, particularly in the unplanned group, whereas BW remained largely stable in both groups. A high BNP ratio (>median) was significantly associated with an increased likelihood of unplanned dialysis initiation (odds ratio [OR], 5.64; 95% confidence interval [CI], 2.90-10.99). For the BW ratio, both weight loss (<25th percentile; OR, 3.47; 95% CI, 1.58-7.65) and weight gain (>75th percentile; OR, 2.33; 95% CI, 1.11-4.87) were associated with an increased likelihood of unplanned dialysis initiation.
LIMITATIONS: Retrospective, single-center design with possible residual confounding and limited generalizability; unavailability of body composition data.
CONCLUSIONS: In patients with advanced CKD, trajectories of BNP, together with BW, were significant predictors of unplanned dialysis initiation. Close monitoring of these parameters might help identify high-risk patients and facilitate a timely dialysis transition.