title: Relationship between the brain natriuretic peptide (BNP) level and remission of diabetic nephropathy with microalbuminuria: a 3-year follow-up study.
abstract: The aim of the study was to examine the relationship between the brain natriuretic peptide (BNP) level and progression or remission of diabetic nephropathy with microalbuminuria for 3 years. The subjects were 100 Japanese type 2 diabetes mellitus outpatients with microalbuminuria. Associations between metabolic parameters at baseline [HbA1c, systolic blood pressure (SBP), urine albumin-creatinine ratio (ACR), estimated glomerular filtration rate (eGFR), and BNP] and the progression or remission of diabetic nephropathy were examined for 3 years. A total of 83 patients were examined at the end of the 3-year period, including 17 with remission to normoalbuminuria, 47 with continuing microalbuminuria, and 19 with progression to macroalbuminuria. HbA1c, ACR, and BNP differed significantly among the 3 groups (p=0.024, p<0.001, p=0.002, respectively). Among baseline factors, HbA1c and BNP were significant predictors of the percentage increase in ACR for 3 years in multiple linear regression analysis (β=0.259, p=0.02; β=0.299, p=0.007, respectively). In multivariate logistic regression analysis, HbA1c and ACR were independently associated with progression of diabetic nephropathy (p=0.008, p=0.023, respectively), and ACR and BNP were independently associated with remission of diabetic nephropathy (p=0.029, p=0.012, respectively). ROC curve analysis gave a cutoff value for BNP of 14.9 pg/ml for prediction of remission of diabetic nephropathy (p=0.016). The BNP level has a relationship with diabetic nephropathy and a low BNP level predicts remission of diabetic nephropathy. Therefore, monitoring of BNP can play an important role in management of diabetic nephropathy.
authors.affiliation: Clinical Research Center, National Hospital Organization, Chiba-East National Hospital, Chiba, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Seki
authors.affiliation: Department of Internal Medicine, Social Insurance Funabashi Central Hospital, Funabashi, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Matsumoto
authors.affiliation: Department of Internal Medicine, Social Insurance Funabashi Central Hospital, Funabashi, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Fukazawa
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000097:blood* / Q000628:therapy; D044466:Asian People; D003928:Diabetic Nephropathies / Q000097:blood* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D012074:Remission Induction
chemical_list: D006442:Glycated Hemoglobin; D020097:Natriuretic Peptide, Brain; C517652:hemoglobin A1c protein, human