Kidney Week

Abstract: SA-PO0435

Temporal Trajectory of N-Terminal Pro-B-Type Natriuretic Peptide (NT-proBNP) and Carbohydrate Antigen (CA-125) Before Dialysis Initiation: Insights into Cardiorenal Interactions in Advanced CKD

Session Information

• CKM: Clinical - Epidemiology and Outcomes
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Cardiovascular-Kidney-Metabolic Health

• 602 Cardiovascular-Kidney-Metabolic Health: Clinical

Authors

• Toapanta Gaibor, Nestor Gabriel, Hospital Universitari Vall d'Hebron, Barcelona, CT, Spain

Nestor Gabriel Toapanta Gaibor, MD

• Padron Perez, Natalia, Hospital Universitari Vall d'Hebron, Barcelona, CT, Spain

Natalia Padron Perez, MD

• Román Cabezas, Mario, Hospital Universitario Virgen del Rocio, Seville, AL, Spain

Mario Román Cabezas, MD

• León-Román, Juan Carlos, Hospital Universitari Vall d'Hebron, Barcelona, CT, Spain

Juan Carlos León-Román, MD

• Bedoya, Hector Luis, Hospital Universitari Vall d'Hebron, Barcelona, CT, Spain

Hector Luis Bedoya, MD

• Toro, Fco Javier, Hospital Universitario Virgen del Rocio, Seville, AL, Spain

Fco Javier Toro, PhD

• Soler, Maria Jose, Hospital Universitari Vall d'Hebron, Barcelona, CT, Spain

Maria Jose Soler, MD, PhD

Background

The identification of biomarkers capable of anticipating the initiation of kidney replacement therapy (KRT) in patients with advanced chronic kidney disease (ACKD) remains an unmet clinical need. NT-proBNP and CA-125 have emerged as potential markers of congestion and cardiorenal dysfunction. Objective: To characterize the temporal trajectory of NT-proBNP and CA-125 in the months preceding KRT initiation and to evaluate their association with cardiac function parameters in patients with ACKD.

Methods

This multicenter retrospective observational study included 221 patients with ACKD who initiated KRT. NT-proBNP and CA-125 levels were analyzed at different time points (12, 9, 6, and 3 months before dialysis initiation, and at KRT initiation). The longitudinal evolution of both biomarkers and their relationship with echocardiographic parameters, including left ventricular ejection fraction (LVEF) and tricuspid annular plane systolic excursion (TAPSE), were evaluated.

Results

A progressive increase in NT-proBNP levels was observed during the months preceding KRT initiation, with consistently higher values in patients starting peritoneal dialysis compared with hemodialysis. CA-125 also showed an upward trend, although with a less pronounced slope. NT-proBNP was inversely associated with cardiac function, showing a negative correlation with LVEF (r = -0.38; p < 0.001) and TAPSE (r = -0.31; p = 0.003). CA-125 showed a more moderate association, reaching statistical significance with TAPSE (r = -0.24; p = 0.037), but not with LVEF. In addition, a positive correlation between both biomarkers was observed (r = 0.36; p < 0.001).

Conclusion

NT-proBNP and CA-125 demonstrate an upward trajectory during the period preceding KRT initiation, suggesting a relevant role of congestion and cardiorenal dysfunction in the progression of ACKD. NT-proBNP appears to be mainly associated with global cardiac dysfunction, whereas CA-125 may reflect congestion phenomena more closely related to right ventricular function.