Association Of B-type Natriuretic Peptide And Clinical Prognosis In Patients With Chronic Kidney Disease

Background and Aims: Patients who is undergoing Chronic Kidney Disease(CKD)or End-Stage Renal Disease(ESRD)have high risk of death,Cardiovascular diseases such as left ventricular hypertrophy,myocardial infarction,acute congestive heart failure,fatal arrhythmia and valve/vascular calcification are important causes of death.The value of B-type natriuretic peptide and N-terminal pro-B-type natriuretic peptide in predicting the risk of cardiovascular events and death in CKD and ESRD patients is controversial.The purpose of this meta-analysis is to evaluate the prognostic value of BNP and NT-proBNP in these patients.Methods: We searched the documents published in PubMed,EMBASE and CNKI from the establishment of the database to October2019.Finally,22 studies in which BNP / NT-proBNP used to predicting all-cause death,cardiovascular events and cardiovascular death in CKD and ESRD patients were included in our meta analysis,and were performed by stata.11.Results: After comprehensive analysis,we found that the increase ofBNP / NT-proBNP was significantly related to all-cause mortality(HR=1.72,95%CI 1.53-1.93),cardiovascular mortality(HR=2.06,95%CI1.66-2.64)and cardiovascular events rate(HR= 1.61,95%CI 1.47-1.76).After testing,there was a certain degree of heterogeneity between the research data,and further meta-regression analysis and sensitivity analysis did not find obvious sources of heterogeneity.Meanwhile,funnel plot and egger detection suggested publication bias(P < 0.05).Conclusion: BNP and NT-proBNP are effective predictors of death and cardiovascular risk in CKD and ESRD patients.