title: Serum NT-proCNP concentrations are elevated in patients with chronic liver diseases and associated with complications and unfavorable prognosis of cirrhosis.
abstract: OBJECTIVE
  C-type natriuretic peptide (CNP) might be an important regulator of vasodilatation, fluid and sodium balance in liver cirrhosis. We aimed at assessing its regulation and prognostic relevance in liver disease patients.
  
  
  METHODS
  We analyzed NT-proCNP serum levels in 193 patients with chronic liver diseases and 43 healthy controls.
  
  
  RESULTS
  Serum NT-proCNP concentrations were significantly elevated in liver disease patients compared to healthy controls, with highest levels in established hepatic cirrhosis, independent of disease etiology. NT-proCNP was associated with complications of liver diseases and portal hypertension, namely ascites, esophageal varices and hepatic encephalopathy. Circulating NT-proCNP correlated inversely with renal function. Importantly, elevated NT-proCNP levels were identified as a predictor of mortality or necessity for transplantation. NT-proCNP levels >2 pmol/L indicated adverse prognosis (sensitivity 66.7%, specificity 72.8%, RR 5.4 [95%-CI 2.6-11.2]).
  
  
  CONCLUSIONS
  Serum NT-proCNP is elevated in advanced liver diseases and has prognostic value in cirrhotic patients.
authors.affiliation: Department of Medicine III, RWTH-University Hospital Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Koch
authors.forename: Henning W
authors.initials: HW
authors.lastname: Zimmermann
authors.forename: Christer
authors.initials: C
authors.lastname: Baeck
authors.forename: Carlo
authors.initials: C
authors.lastname: Schneider
authors.forename: Eray
authors.initials: E
authors.lastname: Yagmur
authors.forename: Christian
authors.initials: C
authors.lastname: Trautwein
authors.forename: Frank
authors.initials: F
authors.lastname: Tacke
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001660:Biliary Tract Diseases / Q000097:blood / Q000150:complications / Q000401:mortality; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D016207:Cytokines / Q000097:blood; D058625:End Stage Liver Disease / Q000097:blood* / Q000175:diagnosis / Q000209:etiology / Q000401:mortality; D005260:Female; D006525:Hepatitis, Viral, Human / Q000097:blood / Q000150:complications / Q000401:mortality; D006801:Humans; D006975:Hypertension, Portal / Q000097:blood / Q000209:etiology; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000097:blood* / Q000175:diagnosis / Q000209:etiology / Q000401:mortality; D008108:Liver Diseases, Alcoholic / Q000097:blood / Q000150:complications / Q000401:mortality; D008297:Male; D008875:Middle Aged; D020098:Natriuretic Peptide, C-Type / Q000097:blood*; D011379:Prognosis; D011498:Protein Precursors / Q000097:blood*; D012372:ROC Curve; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D015415:Biomarkers; D016207:Cytokines; D011498:Protein Precursors; D020098:Natriuretic Peptide, C-Type