Prospective study of neuropeptide Y as an adverse cardiovascular risk factor in end-stage renal disease

Carmine Zoccali, Francesca Mallamaci, Giovanni Tripepi, Francesco A. Benedetto, Saverio Parlongo, Sebastiano Cutrupi, Domenico Iellamo, Graziella Bonanno, Francesco Rapisarda, Pasquale Fatuzzo, Giuseppe Seminara, Alessandro Cataliotti, Lorenzo Salvatore Malatino

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39 Scopus citations


Chronic renal insufficiency is a situation characterized by high plasma concentration of neuropeptide Y (NPY). Because this neuropeptide interferes with cardiovascular (CV) function, it is possible that it is involved in the high CV-related morbidity and mortality of these patients. To test this hypothesis, a follow-up study was performed (average duration, 34 mo; range 0.2 to 52.0 mo) in a cohort of 277 patients with end-stage renal disease receiving chronic dialysis. Univariate analysis revealed that plasma NPY was directly related to plasma norepinephrine (r = 0.37, P < 0.001) and epinephrine (r = 0.17, P = 0.005), exceeding the upper limit of the normal range in the majority of patients with end-stage renal disease (170 of 277, 61%). One hundred thirteen patients had one or more fatal and nonfatal CV events; 112 patients died, 66 of them (59%) of CV causes. Plasma NPY failed to predict all-cause mortality but was an independent predictor of adverse CV outcomes (hazard ratio [10 pmol/L increase in plasma NPY], 1.32; 95% confidence interval, 1.09 to 1. 60; P = 0.004) in a Cox proportional-hazard model that included a series of traditional and nontraditional CV risk factors. Plasma NPY maintained its predictive power for CV events in statistical model including plasma norepinephrine. Plasma NPY predicts incident CV complications in end-stage renal disease. Controlled trials are needed to establish whether interference with the sympathetic system, NPY, or both may reduce the high CV morbidity and mortality of dialysis patients.

Original languageEnglish (US)
Pages (from-to)2611-2617
Number of pages7
JournalJournal of the American Society of Nephrology
Issue number10
StatePublished - Oct 1 2003

ASJC Scopus subject areas

  • Nephrology


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