title: Plasma B-type natriuretic peptide concentration is independently associated with kidney function decline in Japanese patients with chronic kidney disease.
abstract: OBJECTIVE
  The relationship between B-type natriuretic peptide (BNP) concentration and renal outcomes in patients with chronic kidney disease (CKD) remains unclear; therefore, it has not been determined whether BNP is related to renal outcomes, independent of cardiac parameters. This study was designed to clarify whether BNP concentration is associated with renal outcomes in CKD patients, independent of cardiac functional and structural alterations.
  
  
  METHODS
  This prospective observational study included 372 consecutive patients with CKD. The renal endpoint was the composite of doubling of serum creatinine concentration and end-stage renal disease requiring dialysis. BNP concentrations were divided into quartiles. A Cox proportional hazards model was utilized to determine the risk factors for poor renal outcomes.
  
  
  RESULTS
  During a median follow-up of 23.1 months, the renal endpoint was observed in 124 patients, including 14, 18, 37 and 55 patients in the first through fourth BNP quartiles, respectively. After adjustment for covariates, including cardiac parameters such as left atrial diameter, left ventricular mass index, left ventricular ejection fraction, and left ventricular hypertrophy, the hazard ratios (HRs) for renal outcomes became progressively higher for the second [HR, 1.50; 95% confidence interval (CI), 0.70-3.30), third (HR, 2.29; 95% CI, 1.11-4.91), and fourth (HR, 4.29; 95% CI, 2.05-9.39) BNP quartiles when compared with the lowest BNP quartile.
  
  
  CONCLUSIONS
  Higher BNP levels were associated with adverse renal outcomes, independent of cardiac structure and function, suggesting that BNP may be a useful biomarker for exploring factors associated with kidney disease progression.
authors.affiliation: aDepartment of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku bDivision of Nephrology and Clinical Research Institute cDivision of Hypertension and Clinical Research Institute, Department of Internal Medicine, National Kyushu Medical Center Hospital, 1-8-1 Jigyohama, Chuo-ku dDivision of Cardiology and Hypertension, Steel Memorial Yawata Hospital, 1-1-1 Harunomachi, Yahatahigashi-ku, Fukuoka 805-8508, Japan.
authors.forename: Ryota
authors.initials: R
authors.lastname: Yoshitomi
authors.forename: Masaru
authors.initials: M
authors.lastname: Nakayama
authors.forename: Teppei
authors.initials: T
authors.lastname: Sakoh
authors.forename: Akiko
authors.initials: A
authors.lastname: Fukui
authors.forename: Yui
authors.initials: Y
authors.lastname: Shikuwa
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Tominaga
authors.forename: Takuya
authors.initials: T
authors.lastname: Tsuchihashi
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Tsuruya
authors.forename: Takanari
authors.initials: T
authors.lastname: Kitazono
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain