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- Title
Mathematical model to predict B‐type natriuretic peptide levels in haemodialysis patients.
- Authors
Touzot, Maxime; Seris, Pascal; Maheas, Catherine; Vanmassenhove, Jill; Langlois, Anne‐Lyse; Moubakir, Kamal; Laplanche, Sophie; Petitclerc, Thierry; Ridel, Christophe; Lavielle, Marc
- Abstract
Aim: Clinical interpretation of B‐type natriuretic peptide (BNP) levels in haemodialysis (HD) patients for fluid management remains elusive. Methods: We conducted a retrospective observational monocentric study. We built a mathematical model to predict BNP levels, using multiple linear regressions. Fifteen clinical/biological characteristics associated with BNP variation were selected. A first cohort of 150 prevalent HD (from September 2015 to March 2016) was used to build several models. The best model proposed was internally validated in an independent cohort of 75 incidents HD (from March 2016 to December 2017). Results: In cohort 1, mean BNP level was 630 ± 717 ng/mL. Cardiac disease (CD – stable coronary artery disease and/or atrial fibrillation) was present in 45% of patients. The final model includes age, systolic blood pressure, albumin, CD, normo‐hydrated weight (NHW) and the fluid overload (FO) assessed by bio‐impedancemetry. The correlation between the measured and the predicted log‐BNP was 0.567 and 0.543 in cohorts 1 and 2, respectively. Age (β = 3.175e−2, P < 0.001), CD (β = 5.243e−1, P < 0.001) and FO (β = 1.227e−1, P < 0.001) contribute most significantly to the BNP level, respectively, but within a certain range. We observed a logistic relationship between BNP and age between 30 and 60 years, after which this relationship was lost. BNP level was inversely correlated with NHW independently of CD. Finally, our model allows us to predict the BNP level according to the FO. Conclusion: We developed a mathematical model capable of predicting the BNP level in HD. Our results show the complex contribution of age, CD and FO on BNP level. SUMMARY AT A GLANCE: The utility of B‐type natriuretic peptide (BNP) levels in haemodialysis patients to assess fluid status is unclear. The authors have developed a mathematical model to predict BNP levels according to the degree of fluid overload and suggested that clinical studies are now required to determine the utility of this model.
- Subjects
BRITISH National Party (1982- ); MATHEMATICAL models; SYSTOLIC blood pressure; CORONARY disease; ATRIAL fibrillation; HEART diseases; BRAIN natriuretic factor
- Publication
Nephrology, 2020, Vol 25, Issue 1, p82
- ISSN
1320-5358
- Publication type
Article
- DOI
10.1111/nep.13586