Association between renal function and circulating levels of natriuretic peptides (from the Dallas Heart Study).
The relations between renal function and circulating B-type natriuretic peptide (BNP) and the amino-terminal fragment of its prohormone (NT-pro-BNP) in the general population have not been fully elucidated. A total of 2,784 subjects from the Dallas Heart Study, a multiethnic population-based sample of Dallas County, Texas, residents, was studied. Detailed cardiac phenotyping, including magnetic resonance imaging and electron beam computed tomography, as well as measurements of NT-pro-BNP and BNP, were performed. Associations between estimated glomerular filtration rate (eGFR) and both NT-pro-BNP and BNP were evaluated using multivariable statistical analysis techniques. Median eGFR in this young, predominantly healthy population was 97 ml/min/1.73 m(2) (interquartile range 84 to 112). Natriuretic peptide levels were not associated with renal function over the normal range of eGFR. Below a threshold eGFR of 90 ml/min/1.73 m(2), both NT-pro-BNP and BNP increased in an exponential fashion with decreasing eGFR. These associations remained significant after adjustment for multiple potential confounders (p <0.001 for all). For eGFR <90 ml/min/1.73 m(2), the relative increase in NT-pro-BNP was twice as great as that for BNP for a given decrease in eGFR. In conclusion, a threshold effect regarding the association between renal function and natriuretic peptides was shown. With eGFR <90 ml/min/1.73 m(2), both NT-pro-BNP and BNP were inversely and independently associated with renal function, with a greater magnitude of association with renal impairment noted for NT-pro-BNP.
Das
Sandeep R
SR
Donald W Reynolds Cardiovascular Clinical Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA. sandeep.das@utsouthwestern.edu
Abdullah
Shuaib M
SM
Leonard
David
D
Drazner
Mark H
MH
Khera
Amit
A
McGuire
Darren K
DK
de Lemos
James A
JA
D000328:Adult; D005260:Female; D006801:Humans; D007668:Kidney / Q000502:physiology*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*
D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain