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B-Type Natriuretic Peptide and Prognosis of End-Stage Renal Disease A Meta-Analysis.doc

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B-TypeNatriureticPeptideandPrognosisofEnd-Stage RenalDisease:AMeta-Analysis Yun-JiuCheng1.,Feng-JuanYao2.,Li-JuanLiu1.,KaiTang1,Xiao-XiongLin1,Wei-JieLi1,JingZhang1, Su-HuaWu1* 1DepartmentofCardiovascularMedicine,TheFirstAffiliatedHospital,SunYat-SenUniversity,Guangzhou,China,2DepartmentofUltrasonography,TheFirstAffiliated Hospital,SunYat-SenUniversity,Guangzhou,China Abstract Background:TheprognosticimportanceofB-typenatriureticpeptide(BNP)orN-terminalproBNP(NT-proBNP)inpatients withend-stagerenaldisease(ESRD)remainscontroversial. Methodology/PrincipalFindings:WeconductedanunrestrictedsearchfromtheMEDLINEandEMBASEinalllanguages that were published between 1966 and Augest2013. Twenty-seven long-term prospective studies met our inclusion criterias.Fromthepooledanalysis,elevatedBNP/NT-proBNPwassignificantlyassociatedwithincreasedallcausemortality [odds ratio (OR), 3.85; 95% CI, 3.11 to 4.75], cardiovascular mortality (OR, 4.05; 95% CI, 2.53 to 6.84), and cardiovascular events(OR,7.02;95%CI,2.21to22.33).Thefunnelplotshowednoevidenceofpublicationbias.Thecorrespondingpooled positiveandnegativelikelihoodratioforpredictionofallcausemortalitywere1.86(95%CI,1.66to2.08)and0.48(95%CI, 0.42to0.55),respectively. Conclusions/Significance: BNP/NT-proBNP is a promising prognostic tool to risk-stratify the patients with ESRD. Further investigationsarewarrantedtoelucidatethespecificpathogenicmechanismsandtheimpactofotherpotentialprognostic factors. Citation:ChengY-J,YaoF-J,LiuL-J,TangK,LinX-X,etal.(2013)B-TypeNatriureticPeptideandPrognosisofEnd-StageRenalDisease:AMeta-Analysis.PLoS ONE8(11):e79302.doi:10.1371/journal.pone.0079302 Editor:RobertClarke,UniversityofOxford,UnitedKingdom ReceivedFebruary14,2013;AcceptedSeptember23,2013;PublishedNovember13,2013 Copyright: ? 2013 Cheng et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalauthora