Objective To investigate the predictive value of the NT-proBNP level for elderly patients of maintenance hemodialysis and congestive heart failure. Methods 52 cases of maintenance hemodialysis combined with congestive heart failure were selected, 22 cases of congestive heart failure were selected as death group, and another 30 patients with congestive heart failure remission as non-death group. The NT-proBNP level before and during hospitalization was compared between the death group and non-death group. Binary logistic regression methods were used to analyze the correlation factors that affected death, especially the related factors that influenced NT-proBNP of death group. The diagnostic performance of NT-proBNP of patients was evaluated using the receiver-operating characteristic (ROC) curve to determine the prediction efficiency. Results The median value of NT-proBNP in death group before hospitalization was 31000ng/L, compared with 28 500 ng/L in non-death group. The difference was of no statistical significance(P>0.05). The median value of NT-proBNP in death group was 9200 ng/L before admission, significantly higher than 4700ng/L in non-death group. The difference was statistically significant (P<0.01). The left ventricular EF value , mass increase during dialysis and left ventricular enlargement were the main factors that influenced the NT-proBNP level of death group during hospitalization. The NT-proBNP AUC value of death group during hospitalization was 0.962, which was statistically significant(P＜0.05). The sensitivity was 82.4% and the specificity was 84% when NT-proBNP>7650 ng/L served as the boundary value (cutoff value). NT-proBNP AUC value was 0.038 in non-death group during hospitalization, which was of no statistical significance. Conclusions The NT-proBNP level of elderly patients with maintenance hemodialysis combined with congestive heart failure can be used as a prediction index of death during hospitalization.
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2016, Vol. 27 
