Associations between N-Terminal Pro-B-Type Natriuretic Peptide, Body Fluid Imbalance and Quality of Life in Patients Undergoing Hemodialysis: A Cross-Sectional Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.2. Data Collection
2.3. Assessment of Body Fluid Composition
2.4. QOL Assessment
2.5. Statistical Analyses
3. Results
3.1. Population Characteristics
3.2. Association between Body Fluid Imbalance and NT-proBNP
3.3. Association between NT-proBNP and Echocardiographic Findings
3.4. Association between NT-proBNP and QOL
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Patients’ Characteristics | NT-proBNP, pg/mL | p | |||
---|---|---|---|---|---|
Quartile 1 172–1700 (n = 80) | Quartile 2 1720–3410 (n = 81) | Quartile 3 3430–7170 (n = 81) | Quartile 4 7200–69,000 (n = 80) | ||
Age, years | 62 (49–71) | 67 (54–74) | 68 (57–76) | 70 (63–75) | <0.001 |
Male sex, n (%) | 63 (78.8) | 52 (64.2) | 49 (60.5) | 63 (78.8) | 0.76 |
Diabetes mellitus, n (%) | 45 (56.3) | 46 (56.8) | 50 (61.7) | 42 (52.5) | 0.81 |
Dialysis vintage, months | 48 (23–98) | 81 (38–126) | 67 (35–128) | 88 (45–155) | 0.001 |
Cardiovascular disease, n (%) | 13 (16.3) | 15 (18.5) | 10 (12.4) | 17 (21.3) | 0.48 |
Smoker, n (%) | 17 (21.3) | 27 (33.3) | 23 (28.4) | 19 (23.8) | 0.76 |
Body mass index, kg/m2 | 24.3 (20.8–27.3) | 22.9 (20.4–25.1) | 21.1 (19.4–24.3) | 21.0 (19.2–23.9) | <0.001 |
Pre-dialysis body weight, kg | 69.3 (58.3–82.2) | 62.6 (53.0–72.8) | 60.3 (51.2–67.8) | 60.2 (52.8–68.3) | <0.001 |
Post-dialysis body weight, kg | 65.9 (56.3–79.0) | 59.9 (50.6–69.2) | 56.5 (48.4–64.1) | 56.7 (49.8–65.1) | <0.001 |
Ultrafiltration volume, L | 3.2 (2.5–4.3) | 2.9 (2.4–4.0) | 2.9 (2.2–4.0) | 2.9 (2.3–3.7) | 0.06 |
Ultrafiltration volume, % of body weight | 4.9 (4.0–5.9) | 5.2 (4.4–6.0) | 5.2 (4.1–6.2) | 5.1 (4.1–6.2) | 0.31 |
Pre-dialysis systolic BP, mmHg | 140 (126–154) | 144 (129–159) | 150 (131–165) | 154 (133–166) | 0.001 |
Post-dialysis systolic BP, mmHg | 128 (115–148) | 133 (119–150) | 145 (133–165) | 144 (125–164) | <0.001 |
Pre-dialysis diastolic BP, mmHg | 79 (68–88) | 74 (68–88) | 78 (68–87) | 76 (68–85) | 0.98 |
Post-dialysis diastolic BP, mmHg | 75 (69–86) | 75 (66–84) | 78 (66–90) | 75 (65–86) | 0.95 |
Total protein, g/dL | 6.7 (6.4–6.9) | 6.5 (6.2–6.7) | 6.5 (6.2–6.9) | 6.5 (6.2–6.7) | 0.14 |
Serum albumin, mg/dL | 3.7 (3.5–3.8) | 3.6 (3.5–3.8) | 3.5 (3.4–3.7) | 3.5 (3.3–3.7) | <0.001 |
Blood urea nitrogen, mg/dL | 59 (50–71) | 61 (53–72) | 58 (49–67) | 53 (45–62) | 0.001 |
Serum creatinine, mg/dL | 11.36 (9.41–12.87) | 10.67 (9.38–11.89) | 9.93 (8.69–11.60) | 9.56 (8.45–10.79) | <0.001 |
Serum sodium, mEq/L | 139 (138–143) | 139 (138–141) | 139 (137–141) | 139 (138–140) | 0.037 |
Serum potassium, mEq/L | 4.7 (4.2–5.0) | 5.0 (4.5–5.6) | 4.8 (4.5–5.3) | 4.8 (4.4–5.2) | 0.24 |
Serum chloride, mEq/L | 103 (100–105) | 103 (102–105) | 104 (102–106) | 104 (101–106) | 0.60 |
Serum calcium, mg/dL | 8.7 (8.3–8.9) | 8.7 (8.3–9.0) | 8.5 (8.2–8.9) | 8.7 (8.2–8.9) | 0.78 |
Serum phosphorus, mg/dL | 5.6 (5.0–6.2) | 5.6 (5.2–6.4) | 5.5 (5.0–6.4) | 5.5 (4.8–6.1) | 0.31 |
Uric acid, mg/dL | 8.1 (7.3–9.2) | 7.8 (7.1–8.5) | 7.6 (6.9–8.3) | 7.3 (6.5–8.2) | <0.001 |
Total cholesterol, mg/dL | 169 (151–198) | 169 (142–205) | 159 (140–188) | 153 (133–177) | 0.010 |
Triglyceride, mg/dL | 138 (81–204) | 104 (67–154) | 91 (65–133) | 95 (62–114) | <0.001 |
Blood glucose, mg/dL | 117 (98–158) | 109 (89–158) | 111 (94–146) | 112 (96–139) | 0.73 |
Fe, μg/dL | 62 (50–82) | 71 (56–84) | 65 (54–82) | 65 (51–81) | 0.43 |
TIBC, μg/dL | 262 (233–314) | 253 (222–277) | 260 (234–286) | 267 (242–302) | 0.31 |
Ferritin, ng/mL | 49 (29–98) | 66 (40–97) | 54 (33–92) | 59 (33–101) | 0.70 |
Hemoglobin, g/dL | 11.4 (10.7–12.2) | 11.2 (10.8–11.9) | 11.1 (10.7–11.8) | 11.0 (10.5–11.6) | <0.001 |
Hematocrit, % | 34.7 (32.6–37.5) | 33.9 (32.4–36.1) | 33.8 (32.8–35.5) | 33.4 (31.4–35.9) | 0.010 |
C-reactive protein, mg/dL | 0.14 (0.05–0.22) | 0.07 (0.04–0.21) | 0.08 (0.04–0.26) | 0.14 (0.06–0.38) | <0.001 |
Kt/Vurea | 1.71 (1.54–1.94) | 1.88 (1.67–2.08) | 1.87 (1.68–2.18) | 1.85 (1.71–2.07) | 0.07 |
Geriatric nutritional risk index | 101 (95–108) | 97 (92–102) | 93 (88–101) | 93 (87–98) | 0.003 |
CTR in men (n = 227), % | 50.2 (46.4–52.9) | 52.6 (50.8–53.9) | 51.7 (49.4–51.7) | 56.0 (52.6–59.3) | <0.001 |
CTR in women (n = 95), % | 48.4 (46.0–52.3) | 49.4 (45.1–52.2) | 50.2 (46.7–53.5) | 52.8 (49.4–55.2) | <0.001 |
Variables | Unadjusted | Model 1 | Model 2 | |||
---|---|---|---|---|---|---|
β (95% CI) | p | β (95% CI) | p | β (95% CI) | p | |
Age | 0.29 (0.007–0.016) | <0.001 | 0.03 (−0.004–0.006) | 0.59 | ||
Dialysis vintage, months | 0.18 (0.000–0.002) | 0.001 | 0.08 (−0.000–0.001) | 0.08 | 0.05 (−0.000–0.001) | 0.36 |
Body mass index, kg/m2 | −0.22 (−0.042–−0.014) | <0.001 | −0.01 (−0.013–0.016) | 0.86 | ||
Post-dialysis systolic BP, mmHg | 0.25 (0.003–0.076) | <0.001 | 0.19 (0.002–0.006) | 0.006 | 0.15 (0.001–0.005) | 0.006 |
Serum albumin, mg/dL | −0.26 (−0.630–−0.262) | <0.001 | −0.08 (−0.325–0.059) | 0.18 | ||
Hemoglobin, g/dL | −0.18 (−0.141–−0.037) | <0.001 | −0.09 (−0.097–0.010) | 0.11 | −0.02 (−0.060–0.041) | 0.11 |
C-reactive protein, mg/dL | 0.22 (0.083–0.243) | <0.001 | 0.16 (0.044–0.201) | 0.002 | 0.13 (0.024–0.178) | 0.002 |
Geriatric nutritional risk index * | −0.29 (−0.022–−0.010) | <0.001 | −0.20 (−0.016–−0.004) | <0.001 | ||
Phase angle, ° | −0.45 (−0.253–−0.162) | <0.001 | −0.34 (−0.218–−0.091) | <0.001 |
Patients’ Characteristics | NT-proBNP, pg/mL | p | |||
---|---|---|---|---|---|
Quartile 1 172–1700 (n = 80) | Quartile 2 1720–3410 (n = 81) | Quartile 3 3430–7170 (n = 81) | Quartile 4 7200–69,000 (n = 80) | ||
LAD, mm | 36.0 (32.0–38.6) | 36.2 (33.3–39.2) | 37.0 (33.0–41.5) | 40.2 (36.1–44.4) | <0.001 |
LVDd, mm | 45.4 (39.9–49.3) | 45.0 (41.5–51.7) | 44.3 (40.4–49.3) | 48.0 (42.0–51.4) | 0.046 |
LVDs, mm | 29.4 (25.0–32.1) | 29.8 (24.5–34.2) | 28.8 (26.5–33.0) | 31.3 (27.8–35.3) | 0.003 |
PWT, mm | 10.1 (9.0–11.7) | 10.5 (9.6–12.0) | 10.8 (9.8–12.8) | 11.6 (10.0–12.9) | <0.001 |
IVST, mm | 10.2 (8.6–12.0) | 11.2 (10.0–12.3) | 11.0 (10.0–12.2) | 11.8 (10.0–13.2) | <0.001 |
EF | 65.3 (60.4–70.0) | 65.1 (59.6–72.6) | 63.3 (58.9–68.1) | 62.1 (56.1–67.8) | <0.001 |
LVMI, g/m2 | 87 (72–106) | 107 (93–134) | 107 (89–126) | 124 (104–149) | <0.001 |
QoL Domains | NT-proBNP, pg/mL | p | |||
---|---|---|---|---|---|
Quartile 1 172–1700 (n = 80) | Quartile 2 1720–3410 (n = 81) | Quartile 3 3430–7170 (n = 81) | Quartile 4 7200–69,000 (n = 80) | ||
Physical health domains | |||||
Physical functioning | 85 (66–95) | 85 (70–95) | 75 (60–90) | 70 (50–80) | <0.001 |
Role limitations caused by physical health problems | 75 (25–100) | 75 (13–100) | 75 (0–100) | 38 (0–100) | 0.004 |
Bodily pain | 78 (55–90) | 70 (45–90) | 68 (45–90) | 59 (45–80) | 0.013 |
General health | 50 (40–55) | 50 (35–60) | 45 (35–50) | 45 (30–50) | 0.05 |
Mental health domains | |||||
Vitality | 58 (40–70) | 60 (45–75) | 55 (40–75) | 50 (31–65) | 0.025 |
Social functioning | 88 (50–100) | 75 (50–100) | 75 (56–100) | 75 (50–100) | 0.14 |
Role limitations caused by emotional health problems | 100 (83–100) | 100 (33–100) | 67 (0–100) | 67 (0–100) | 0.008 |
Emotional well-being | 72 (56–84) | 76 (56–88) | 68 (56–82) | 64 (48–80) | 0.018 |
Kidney disease-specific domains | |||||
Symptoms | 83 (73–90) | 88 (78–94) | 83 (74–95) | 79 (71–88) | 0.031 |
Effects of kidney disease | 78 (69–88) | 81 (69–91) | 78 (63–91) | 77 (63–88) | 0.10 |
Burden of kidney disease | 38 (25–50) | 44 (25–56) | 38 (25–56) | 31 (25–50) | 0.83 |
Work status | 50 (0–100) | 50 (0–100) | 50 (0–50) | 50 (0–50) | 0.003 |
Cognitive function | 93 (87–100) | 93 (87–100) | 93 (80–100) | 93 (80–100) | 0.57 |
Quality of social interaction | 87 (67–100) | 93 (50–100) | 93 (55–100) | 68 (47–87) | 0.94 |
Sleep | 55 (43–70) | 68 (50–80) | 63 (53–80) | 59 (48–73) | 0.32 |
Social support | 67 (67–83) | 67 (67–83) | 67 (67–100) | 67 (67–83) | 0.36 |
Dialysis staff encouragement | 75 (50–100) | 75 (50–100) | 75 (67–100) | 75 (67–88) | 0.38 |
Patient satisfaction | 83 (67–100) | 83 (83–100) | 83 (67–100) | 83 (67–83) | 0.60 |
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Yamazaki, K.; Ishii, S.; Hitaka, M.; Masai, M.; Ohashi, Y. Associations between N-Terminal Pro-B-Type Natriuretic Peptide, Body Fluid Imbalance and Quality of Life in Patients Undergoing Hemodialysis: A Cross-Sectional Study. J. Clin. Med. 2023, 12, 7356. https://doi.org/10.3390/jcm12237356
Yamazaki K, Ishii S, Hitaka M, Masai M, Ohashi Y. Associations between N-Terminal Pro-B-Type Natriuretic Peptide, Body Fluid Imbalance and Quality of Life in Patients Undergoing Hemodialysis: A Cross-Sectional Study. Journal of Clinical Medicine. 2023; 12(23):7356. https://doi.org/10.3390/jcm12237356
Chicago/Turabian StyleYamazaki, Keisuke, Shingo Ishii, Mai Hitaka, Motoyuki Masai, and Yasushi Ohashi. 2023. "Associations between N-Terminal Pro-B-Type Natriuretic Peptide, Body Fluid Imbalance and Quality of Life in Patients Undergoing Hemodialysis: A Cross-Sectional Study" Journal of Clinical Medicine 12, no. 23: 7356. https://doi.org/10.3390/jcm12237356