Prognostic utility of NT-proBNP greater than 70,000 pg/mL in patients with end stage renal disease

Background Elevated NT-pro-BNP level has been identified as an independent predictor of mortality in heart failure and end stage renal disease. Previous studies diverge on NT-proBNP values predictive of mortality. The highest recorded NT-proBNP value in our institution is >70,000 pg/ml. No study to date has determined the association between a uniformly elevated NT-proBNP level and mortality. Methods Retrospective data from January 1, 2012 through January 30, 2016 was collected from patients with NT-proBNP>70,000 pg/ml. Mortality rate was determined via chart review or through the social security death index. Additional variables were gathered via systematic chart review. Results All-cause mortality was 45.39%, with a mean survival time of 204.1 days. There was a statistically significant difference in mortality (p=0.0089) and survival (p=0.0043) among patients with an ejection fraction 70,000 pg/ml, mortality rate is nearly 50%. Systolic heart failure with a left ventricular ejection fraction of <25% is a strong predictor of mortality in these patients.