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Kidney function crucially affects B ‐type natriuretic peptide ( BNP ), N ‐terminal pro BNP and their relationship
Author(s) -
Takase Hiroyuki,
Dohi Yasuaki
Publication year - 2014
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.12234
Subject(s) - natriuretic peptide , renal function , medicine , kidney , endocrinology , kidney disease , heart failure
Background B ‐type natriuretic peptide ( BNP ) and N ‐terminal pro BNP ( NT ‐pro BNP ) are useful biomarkers in the management of heart failure. Both peptides are secreted into the circulation after cleavage of their precursor pro BNP and excreted from the kidney in the active form or as metabolites. We investigated effects of kidney function on the levels and association of these peptides. Materials and methods Plasma concentrations of BNP and serum concentrations of NT ‐pro BNP were measured in 229 outpatients of our cardiology department (male/female = 138/91, mean age= 68 years) and 53 hospital outpatients on chronic haemodialysis (30/23, 68 years). Kidney function in nondialysed patients was assessed by estimated glomerular filtration rate ( eGFR ; mL/min/1·73 m 2 ) and categorised across five stages. Effects of kidney function on BNP , NT ‐pro BNP and their relationship were investigated. Results Deterioration in kidney function increased BNP and NT ‐pro BNP levels, as well as the NT ‐pro BNP / BNP ratio, and these values were highest in patients on haemodialysis. The e GFR inversely correlated with BNP ( r = –0·472), NT ‐pro BNP ( r = –0·579), and the NT ‐pro BNP / BNP ratio ( r = –0·454, all P < 0·0001). A significant correlation was observed between BNP and NT ‐pro BNP at all stages of kidney function including patients on haemodialysis, but the correlation was significantly affected by kidney function. Conclusions Although circulating levels of both BNP and NT ‐pro BNP increased with deteriorating kidney function, the impact of kidney function on NT ‐pro BNP was much more pronounced than that on BNP . Kidney function should be taken into account when interpreting data on BNP , NT ‐pro BNP and their relationship.