What question did this study set out to answer?

To examine whether longitudinal changes in BNP and body weight can predict unplanned dialysis initiation in chronic kidney disease patients.

April 4, 2026Kidney Medicine0 citationsOpen Access

Pre-Dialysis Trajectory of BNP and Body Weight in Chronic Kidney Disease Patients: A Predictive Marker for Unplanned Dialysis Initiation

SSShinnosuke Sugihara TNTakashin Nakayama TATatsuhiko Azegami

Key Result

High pre-dialysis BNP ratio (OR 5.64) and significant body weight loss (OR 3.47) or gain (OR 2.33) strongly predicted unplanned dialysis initiation in patients with chronic kidney disease.

Key Points

To examine whether longitudinal changes in BNP and body weight can predict unplanned dialysis initiation in chronic kidney disease patients.
Retrospective cohort study of 231 CKD patients initiating dialysis from 2014 to 2024.
Evaluated BNP and body weight ratios as predictors based on their values before dialysis initiation.
Assessed associations using multivariable logistic regression models.
59% of patients had planned dialysis initiation while 41% had unplanned.
High BNP ratio (>median) significantly increased the likelihood of unplanned dialysis (OR 5.64).
Weight loss (<25th percentile) was associated with increased likelihood (OR 3.47), and weight gain (>75th percentile) also showed increased likelihood (OR 2.33).

Structured PICO

Do longitudinal changes in brain natriuretic peptide (BNP) and body weight predict unplanned dialysis initiation in patients with advanced CKD?

Population

Chronic kidney disease (CKD) patients initiating maintenance dialysis (median age 70, 29% female)

Outcome

Unplanned dialysis initiationhard clinical

In patients with advanced CKD, a high pre-dialysis BNP ratio and significant body weight changes strongly predict the need for unplanned dialysis initiation.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Rationale 95% confidence interval CI, 2.90-10.99).For the BW ratio, both weight loss (75th percentile; OR, 2.33; 95% CI, 1.11-4.87)were associated with an increased likelihood of unplanned dialysis initiation.Limitations: Retrospective, single-center design with possible residual confounding and limited generalizability; unavailability of body composition data. Conclusions:In patients with advanced CKD, trajectories of BNP, together with BW, were significant predictors of unplanned dialysis initiation.Close monitoring of these parameters might help identify high-risk patients and facilitate a timely dialysis transition.

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