Elevated brain natriuretic peptide is associated with abnormal heart geometry in children with chronic kidney disease.
OBJECTIVE
It was to establish whether brain natriuretic peptide (BNP) might predict cardiac dysfunction in children with chronic kidney disease (CKD).


METHODS
The relation between BNP, echocardiography and risk factors (hypertension, anemia, lipids, CRP, hyperparathyroidism) was investigated in 46 children (10 pre-dialysis patients, 14 on dialysis, 11 children with kidney transplants, and 11 healthy controls). Data on BNP were transformed into common logarithms (log(10) BNP, log BNP).


RESULTS
log BNP was significantly higher in dialysis patients when compared to controls (2.09 +/- 0.78 vs. 1.43 +/- 0.34 pg/ml, p = 0.012) and patients in the pre-dialysis stage (2.09 +/- 0.78 vs. 1.52 +/- 0.42 pg/ml, p = 0.039). log BNP in transplanted children was not significantly different from healthy children (2.09 +/- 0.78 vs. 1.71 +/- 0.46 pg/ml, p = 0.19). Abnormal heart geometry (concentric and eccentric hypertrophy, concentric remodeling) was found in 19 patients (54.28%). A significant correlation was observed between log BNP and ventricular hypertrophy (r = 0.515, p = 0.001). Compared to controls higher log BNP was seen in children with eccentric hypertrophy than in children with concentric hypertrophy (2.178 +/- 0.956 vs. 1.496 +/- 0.395 pg/ml, p = 0.05, or 1.982 +/- 0.618 vs. 1.496 +/- 0.395, p = 0.04).


CONCLUSIONS
BNP might predict an abnormal geometry in children with CKD.
Department of Pediatrics, Medical Faculty UPJS and DFN, Kosice, Slovak Republic.
J
J
Hedvig
L
L
Podracká
D
D
Potoceková
D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D006332:Cardiomegaly / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology; D016022:Case-Control Studies; D002648:Child; D002908:Chronic Disease; D004452:Echocardiography; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular; D007674:Kidney Diseases / Q000150:complications*; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011237:Predictive Value of Tests; D012307:Risk Factors; D055815:Young Adult
D015415:Biomarkers; D020097:Natriuretic Peptide, Brain