Multimarker Approach to Risk Stratification for Long-Term Mortality in Patients on Chronic Hemodialysis

• Published in: Circulation Journal 2015/02/25, Vol.79(3), pp.656-663
• Main Authors: Ishii, Junnichi, Takahashi, Hiroshi, Kitagawa, Fumihiko, Kuno, Atsuhiro, Okuyama, Ryuunosuke, Kawai, Hideki, Muramatsu, Takashi, Naruse, Hiroyuki, Motoyama, Sadako, Matsui, Shigeru, Hasegawa, Midori, Aoyama, Toru, Kamoi, Daisuke, Kasuga, Hirotake, Izawa, Hideo, Ozaki, Yukio, Yuzawa, Yukio
• Format: Article
• Language: English
• Subjects: Aged; B-type natriuretic peptide; Biomarkers - blood; C-Reactive Protein - metabolism; Cardiac troponin T; Disease-Free Survival; Female; Follow-Up Studies; Hemodialysis; High-sensitivity C-reactive protein; Humans; Male; Middle Aged; Mortality; Natriuretic Peptide, Brain - blood; Prospective Studies; Renal Dialysis - mortality; Risk Factors; Survival Rate; Troponin T - blood
• ISSN: 1346-9843; 1347-4820
• DOI: 10.1253/circj.CJ-14-0915

Background:We prospectively investigated the prognostic value of the combined use of cardiac troponin T (TnT), B-type natriuretic peptide (BNP), and high-sensitivity C-reactive protein (CRP) for long-term mortality in hemodialysis (HD) patients.Methods and Results:Baseline measurements of TnT, BNP, and CRP were performed in 516 patients on chronic HD. Patients were followed up for 10 years. Using the Cox multivariate model with these 3 biomarkers as variables categorized into tertiles for mortality, a simplified score was obtained by underscoring individual biomarkers based on the adjusted hazard ratio (HR). The multimarker score was defined as the sum of these points. TnT, BNP, and CRP levels were individually independent predictors for mortality (P