title: Brain natriuretic peptide is related to carotid plaques and predicts atherosclerosis in pre-dialysis patients with chronic kidney disease.
abstract: BACKGROUND
  Although brain natriuretic peptide (BNP) concentration has been associated with atherosclerosis and ischemic cardiovascular diseases (CVD) in the general population, less is known about this relationship in pre-dialysis chronic kidney disease (CKD) patients.
  
  
  METHODS
  We prospectively analyzed 227 pre-dialysis patients with CKD [median estimated glomerular filtration rate (eGFR): 28.82 (11.65-48.20) ml/min/1.73 m(2)]. At enrollment, BNP concentrations, biochemical and echocardiographic parameters were measured, and carotid artery ultrasound was performed. Patients were prospectively followed for a mean 31.8 months (range 0.5-57.0 months). Ischemic CV events and patient outcomes were recorded.
  
  
  RESULTS
  Median BNP concentration at enrollment was significantly higher in the CKD patients than in a control group [53.9 (16.2-181.0) pg/ml vs. 9.4 (7.0-15.3) pg/ml, P<0.01]. BNP concentration was positively related with the carotid intima-media thickness of the common carotid artery (CCA-IMT) and left ventricular mass index (LVMI) and was significantly higher in patients with than without carotid plaques (P<0.01). Logistic regression analysis confirmed that lgBNP concentration was independently correlated with carotid plaques. Thirty-two patients experienced ischemic cardiovascular (ICV) events during follow-up. Kaplan-Meier analysis showed that cumulative survival without new ICV events was better in patients with lower than with higher BNP concentrations (P<0.01). Cox regression analysis showed that BNP was an independent risk factor for ICV events (HR=3.167, 95%CI=1.398-7.171, P<0.01).
  
  
  CONCLUSIONS
  Similar to findings in the general population, elevated BNP level is related to atherosclerosis and an increased risk of ICV events in pre-dialytic CKD patients.
authors.affiliation: Renal Division, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, PR China.
authors.forename: Wenyan
authors.initials: W
authors.lastname: Zhou
authors.forename: Zhaohui
authors.initials: Z
authors.lastname: Ni
authors.forename: Zanzhe
authors.initials: Z
authors.lastname: Yu
authors.forename: Beili
authors.initials: B
authors.lastname: Shi
authors.forename: Qin
authors.initials: Q
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D050197:Atherosclerosis / Q000097:blood* / Q000000981:diagnostic imaging; D002318:Cardiovascular Diseases; D002340:Carotid Artery Diseases / Q000097:blood*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging; D059168:Carotid Intima-Media Thickness / Q000706:statistics & numerical data*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D058226:Plaque, Atherosclerotic / Q000097:blood / Q000000981:diagnostic imaging; D011379:Prognosis; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000097:blood*; D012307:Risk Factors
chemical_list: D020097:Natriuretic Peptide, Brain