Correlation and prognostic utility of B-type natriuretic peptide and its amino-terminal fragment in patients with chronic kidney disease

• Published in: American journal of clinical pathology Vol. 126; no. 4; pp. 506 - 512
• Main Authors: AUSTIN, Wendy J, BHALLA, Vikas, HERNANDEZ-ARCE, Israel, ISAKSON, Susan R, BEEDE, Jennifer, CLOPTON, Paul, MAISEL, Alan S, FITZGERALD, Robert L
• Format: Journal Article
• Language: English
• Published: Chicago, IL American Society of Clinical Pathologists 01.10.2006
• Subjects: Aged; Biological and medical sciences; Biomarkers - blood; Chronic Disease; Female; Hospitalization - statistics & numerical data; Humans; Investigative techniques, diagnostic techniques (general aspects); Kidney Diseases - blood; Kidney Diseases - complications; Kidney Diseases - diagnosis; Kidney Diseases - mortality; Kidneys; Male; Medical sciences; Natriuretic Peptide, Brain - blood; Nephrology. Urinary tract diseases; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Peptide Fragments - blood; Prognosis; Prospective Studies; Protein Precursors - blood; Survival Rate; Urinary system involvement in other diseases. Miscellaneous; Ventricular Dysfunction, Left - blood; Ventricular Dysfunction, Left - complications; Ventricular Dysfunction, Left - diagnosis; Ventricular Dysfunction, Left - mortality; Kidney disease; Human; Brain natriuretic peptide; Correlation; Urinary system disease; Prognosis; Left ventricular dysfunction; Chronic kidney disease; Fragment; Fragmentation; Anatomic pathology; B-type natriuretic peptide; Aminoacid sequence
• ISSN: 0002-9173; 1943-7722
• DOI: 10.1309/M7AAXA0J1THMNCDF

This study compared the correlation and prognostic utility of B-type natriuretic peptide (BNP) and the N-terminal fragment of proBNP (NT-proBNP) in 171 outpatients with renal dysfunction. The NT-proBNP correlated well with BNP in all cases (r = 0.911; P pound .01), regardless of degree of renal impairment or type of left ventricular dysfunction. BNP and NT-proBNP concentrations (P < .005) and their ratios (P pound .01) increased as the glomerular filtration rate (GFR) declined, indicating a greater effect of GFR on NT-proBNP levels. Both natriuretic peptide levels were higher in patients with systolic dysfunction (P < .05) compared with patients with normal echocardiograms. In contrast, BNP and NT-proBNP levels were below the diagnostic cutoffs for congestive heart failure exacerbations in patients with normal heart function or diastolic dysfunction, with no statistical difference between these groups (P = .99). Both peptides are useful prognostic tools for predicting mortality and cardiac hospitalization in renal patients.