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논문분류	춘계학술대회 초록집
제목	Optimal cutoffs of NT-proBNP for risk prediction in new-onset heart failure in chronic kidney disease across eGFR category
저자	Yi Lu
출판정보	2024; 2024(1):
키워드
초록	Objectives: The predictive utility of N-terminal pro-B-type natriuretic peptide (NT-proBNP) for new-onset heart failure (HF) in chronic kidney disease (CKD) patients, especially in advanced CKD, remains confused. We aimed to describe the reference value of NT-proBNP, investigate the prognostic ability of NT-proBNP and identify the optimal cutoffs of NT-proBNP for risk prediction in new-onset HF in CKD patients without HF history across a wide distribution of estimated glomerular filtration rate (eGFR) category. Methods: This retrospective cohort study enrolled CKD patients without previous HF history who had at least one record of NT-proBNP from China Renal Data System database. Included participants were divided into G1-2, G3a, G3b, G4 and G5 according to eGFR. We described the reference value of NT-proBNP in CKD patients without HF with different CKD stages. A follow-up cohort was created to assess the association of NT-proBNP and new-onset HF by Cox regression model and restricted cubic spline. Optimal cutoffs of NT-proBNP for the risk prediction in new-onset HF were identified across eGFR category. Results: Among 36663 patients with CKD without HF, the reference value of NT-proBNP elevated with eGFR decreased. Follow-up cohort included 18261 eligible participants. NT-proBNP was positively associated with the risk of new-onset HF and improved the predictive ability of clinical variables to evaluate the risk of HF in different CKD stages. The non-linear relationship between NT-proBNP and new-onset HF shaped reversed L. Furthermore, the optimal cutoffs of NT-proBNP to predict new-onset HF increased as eGFR reduced in CKD (661, 834, 998, 1407, 5079 pg/mL, for G1-5, respectively), with a moderate discrimination in new-onset HF prediction within 6 month. Conclusions: In CKD without HF, NT-proBNP maintained its prognostic value for the risk prediction in new-onset HF in different CKD stages. As the eGFR declined, the eGFR-specific reference values and optimal cutoffs of NT-proBNP to predict new-onset HF elevated.
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