TY - JOUR
T1 - Mathematical model to predict B-type natriuretic peptide levels in haemodialysis patients
AU - Touzot, Maxime
AU - Seris, Pascal
AU - Maheas, Catherine
AU - Vanmassenhove, Jill
AU - Langlois, Anne Lyse
AU - Moubakir, Kamal
AU - Laplanche, Sophie
AU - Petitclerc, Thierry
AU - Ridel, Christophe
AU - Lavielle, Marc
N1 - Publisher Copyright:
© 2019 Asian Pacific Society of Nephrology
PY - 2020/1/1
Y1 - 2020/1/1
N2 - 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.
AB - 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.
KW - B-type natriuretic peptide
KW - cardiovascular disease
KW - dialysis
KW - modelling
U2 - 10.1111/nep.13586
DO - 10.1111/nep.13586
M3 - Article
C2 - 30887608
AN - SCOPUS:85065470386
SN - 1320-5358
VL - 25
SP - 82
EP - 89
JO - Nephrology
JF - Nephrology
IS - 1
ER -
