Plasma levels of natriuretic peptides and development of chronic kidney disease.
BACKGROUND
Plasma levels of atrial and brain natriuretic peptides (ANP and BNP) are increased in patients with chronic kidney disease (CKD) complicated with deteriorated kidney function, but the relationship between the plasma level of ANP or BNP and the future development of CKD is unclear.


METHODS
We measured the plasma ANP and BNP levels of 294 local residents without CKD in a Japanese community (56.5 ± 10.4 years, mean ± S.D.), who were followed up for the development of CKD over the next 7 years.


RESULTS
Sixty-three residents developed CKD during the follow-up period, and the baseline level of plasma ANP of these residents was significantly higher than in those without CKD development. Kaplan-Meier analysis showed that the residents with higher ANP than the median value developed CKD more frequently than those with lower ANP. The association between plasma ANP level and CKD development was found to be independent of baseline estimated glomerular filtration rate by a Cox proportional hazards model, while this association became insignificant when adjusted by age; plasma ANP was significantly correlated with age. Compared with ANP, the relationship between plasma BNP and CKD development was unclear in these analyses.


CONCLUSIONS
Age-related elevation of plasma ANP levels preceded the development of CKD in the general population of Japan, raising a possibility for ANP being involved in the development of CKD.
Frontier Science Research Center, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan. nogawa@phoenix.ac.jp.|Department of Internal Medicine, Circulatory and Body Fluid Regulation, Faculty of Medicine, University of Miyazaki, Kiyotake, Miyazaki, 889-1692, Japan. nogawa@phoenix.ac.jp.|Department of Occupational Therapy, Kyushu University of Health and Welfare School of Health and Science, Nobeoka, Miyazaki, 882-8508, Japan. nogawa@phoenix.ac.jp.
Noriyuki
N
Ogawa
Department of Internal Medicine, Circulatory and Body Fluid Regulation, Faculty of Medicine, University of Miyazaki, Kiyotake, Miyazaki, 889-1692, Japan. hiroshi_komura@med.miyazaki-u.ac.jp.
Hiroshi
H
Komura
Frontier Science Research Center, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan. kuwasako@med.miyazaki-u.ac.jp.
Kenji
K
Kuwasako
Department of Internal Medicine, Circulatory and Body Fluid Regulation, Faculty of Medicine, University of Miyazaki, Kiyotake, Miyazaki, 889-1692, Japan. kazuokit@med.miyazaki-u.ac.jp.
Kazuo
K
Kitamura
Frontier Science Research Center, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan. jkjpn@med.miyazaki-u.ac.jp.
Johji
J
Kato
D000328:Adult; D000367:Age Factors; D000368:Aged; D009320:Atrial Natriuretic Factor / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D016016:Proportional Hazards Models; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000453:epidemiology*; D012307:Risk Factors
D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor