title: Anaemia and renal dysfunction are independently associated with BNP and NT-proBNP levels in patients with heart failure.
abstract: BACKGROUND
  Anaemia may affect B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) levels, but this has not been well described in heart failure (HF) patients without the exclusion of patients with renal dysfunction.
  
  
  OBJECTIVE
  To study the influence of both anaemia and renal function on BNP and NT-proBNP levels in a large group of hospitalised HF patients.
  
  
  RESULTS
  We studied 541 patients hospitalised for HF (mean age 71+/-11 years, 62% male, and left ventricular ejection fraction 0.33+/-0.14). Of these patients, 30% (n=159) were anaemic (women: Hb<7.5 mmol/l, men: Hb<8.1 mmol/l). Of the 159 anaemic patients, 73% had renal dysfunction (eGFR<60 ml/min/1.73 m2) and of the non-anaemic patients, 57% had renal dysfunction. BNP and NT-proBNP levels were measured in all patients before discharge. In multivariable analyses both plasma haemoglobin and eGFR were independently related to the levels of BNP and NT-proBNP (standardised beta's of -0.16, -0.14 [BNP] and -0.19, -0.26 [NT-proBNP] respectively, P-values<0.01).
  
  
  CONCLUSIONS
  Anaemia and renal dysfunction are related to increased BNP and NT-proBNP levels, independent of the severity of HF. These results indicate that both anaemia and renal dysfunction should be taken into consideration during the interpretation of BNP and NT-proBNP levels in HF patients.
authors.affiliation: Department of Cardiology, Thoraxcenter, University Medical Centre Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands.
authors.forename: Jochem
authors.initials: J
authors.lastname: Hogenhuis
authors.forename: Adriaan A
authors.initials: AA
authors.lastname: Voors
authors.forename: Tiny
authors.initials: T
authors.lastname: Jaarsma
authors.forename: Arno W
authors.initials: AW
authors.lastname: Hoes
authors.forename: Hans L
authors.initials: HL
authors.lastname: Hillege
authors.forename: Johannes A
authors.initials: JA
authors.lastname: Kragten
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: van Veldhuisen
mesh_terms: D000368:Aged; D000740:Anemia / Q000097:blood*; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006333:Heart Failure / Q000097:blood*; D006801:Humans; D007674:Kidney Diseases / Q000097:blood*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D003404:Creatinine