title: Correlation and prognostic utility of B-type natriuretic peptide and its amino-terminal fragment in patients with chronic kidney disease.
abstract: 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.
authors.affiliation: Division of Cardiology and the Department of Medicine, Veteran Affairs Healthcare System San Diego and University of California, San Diego, USA.
authors.forename: Wendy J
authors.initials: WJ
authors.lastname: Austin
authors.forename: Vikas
authors.initials: V
authors.lastname: Bhalla
authors.forename: Israel
authors.initials: I
authors.lastname: Hernandez-Arce
authors.forename: Susan R
authors.initials: SR
authors.lastname: Isakson
authors.forename: Jennifer
authors.initials: J
authors.lastname: Beede
authors.forename: Paul
authors.initials: P
authors.lastname: Clopton
authors.forename: Alan S
authors.initials: AS
authors.lastname: Maisel
authors.forename: Robert L
authors.initials: RL
authors.lastname: Fitzgerald
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002908:Chronic Disease; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007674:Kidney Diseases / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011379:Prognosis; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood; D015996:Survival Rate; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000401:mortality
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D011498:Protein Precursors; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain