title: Urinary NT-proBNP and ductal closure in preterm infants.
abstract: OBJECTIVE
  To explore the association of urinary N-terminal pro-brain natriuretic peptide (NT-proBNP) concentrations and closure of patent ductus arteriosus (PDA) in preterm infants.
  
  
  METHODS
  Blinded prospective study involving 136 preterm infants (median (interquartile range) gestational age 28 (26 to 30) weeks; birth weight 1030 (780 to 1270) g). NT-proBNP was determined in urine collected on day of life (DOL) 2, 7, 14 and 28.
  
  
  RESULTS
  Urinary NT-proBNP/creatinine ratios declined continuously between DOL 2 (74 (17 to 248) μg g(-1)) and DOL 28 (4 (2 to 12) μg g(-1)) and were significantly elevated in ventilated infants on DOL 2, 7 and 14, and in ventilated infants with a hemodynamically significant PDA on DOL 2. Furthermore, urinary NT-proBNP/creatinine ratios on day 14 were higher in 14 ventilated infants who did not respond to pharmacological treatment and subsequently required surgical PDA closure (247 (214 to 547) μg g(-1)) than in ventilated infants (n=7) with successful pharmacological PDA closure (55 (21 to 114) μg g(-1); P<0.05). A cutoff >210 μg g(-1) on day 14 had a sensitivity of 75% and specificity of 100% for predicting non-responsiveness to pharmacological treatment.
  
  
  CONCLUSIONS
  Measurement of urinary NT-proBNP is a new and simple non-invasive test for preterm infants, which may be helpful in guiding PDA treatment decisions.
authors: Department of Neonatology, Klinik für Neonatologie, Charité University Medical Center, Berlin, Germany. christoph.czernik@charite.de
authors: C
authors: C
authors: Czernik
authors: B
authors: B
authors: Metze
authors: C
authors: C
authors: Müller
authors: C
authors: C
authors: Bührer
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D015415:Biomarkers / Q000652:urine; D003401:Creatine / Q000652:urine; D004374:Ductus Arteriosus, Patent / Q000000981:diagnostic imaging / Q000188:drug therapy*; D018618:Echocardiography, Doppler, Color; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D020097:Natriuretic Peptide, Brain / Q000652:urine*; D010446:Peptide Fragments / Q000652:urine*; D011446:Prospective Studies; D012680:Sensitivity and Specificity
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D003401:Creatine; D007213:Indomethacin