title: [Value of N-terminal pro brain natriuretic peptide in predicting acute kidney injury in patients with acute decompensated chronic heart failure].
abstract: OBJECTIVE
  To investigate the prognostic value of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) in the development of acute kidney injury (AKI) in patients with acute decompensated chronic heart failure (ADCHF).
  
  
  METHODS
  Eighty-three patients (55 (66%) men and 28 (34%) women; mean age, 65±11 years) with ADCHF were examined. AKI was diagnosed and classified according to the 2012 Kidney Disease Improving Global Outcomes Clinical Practice guidelines. To rule out contrast-induced AKI, the investigation enrolled only patients in whom radiopague agents had not been injected 7 days before and during hospitalization. Enzyme immunoassay was used to determine serum NT-proBNP concentrations in all the patients upon hospital admission.
  
  
  RESULTS
  AKI was diagnosed in 18 (22%) patients, 13 (16%) had Stage I, 4 (5%) had Stage II, and 1 (1%) had Stage III. The serum concentration of NT-proBNP was significantly higher in patients with AKI than that in the other patients [1512.1 (981.0; 2246.2) and 861.8 (499.0; 1383.6) pg/ml (p=0.008). The rise in NT-proBNP concentrations of more than 942 pg/ml was established to be associated with a considerable increase in the risk of AKI (relative risk (RR) was 4.3; 95% confidence interval (CI), 1.27-14.90; p=0.02). RОС analysis indicated that a NT-proBNP level of >942 pg/ml allows prediction of AKI with a sensitivity of 78% (52; 94) and a specificity of 55% (44; 69) (AUC=0.70; p=0.006). Four (5%) patients died in hospital. NT-proBNP levels in all the dead were greater than 942 pg/ml. Two of the 4 deceased patients had AKI.
  
  
  CONCLUSIONS
  A high level of NT-proBNP in a patient with ADCHF during hospitalization can serve as a biomarker for high risk of AKI and for high mortality rates.
authors.affiliation: Ulyanovsk State University, Ulyanovsk, Russia.
authors.forename: M V
authors.initials: MV
authors.lastname: Menzorov
authors.affiliation: Ulyanovsk State University, Ulyanovsk, Russia.
authors.forename: A M
authors.initials: AM
authors.lastname: Shutov
authors.affiliation: Ulyanovsk State University, Ulyanovsk, Russia.
authors.forename: V I
authors.initials: VI
authors.lastname: Midlenko
authors.affiliation: Ulyanovsk State University, Ulyanovsk, Russia.
authors.forename: N V
authors.initials: NV
authors.lastname: Larionova
authors.affiliation: Ulyanovsk State University, Ulyanovsk, Russia.
authors.forename: I V
authors.initials: IV
authors.lastname: Morozova
authors.affiliation: Ulyanovsk State University, Ulyanovsk, Russia.
authors.forename: O V
authors.initials: OV
authors.lastname: Akulova
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000209:etiology; D000368:Aged; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D002908:Chronic Disease; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis / Q000378:metabolism / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000032:analysis / Q000097:blood; D010446:Peptide Fragments / Q000032:analysis / Q000097:blood; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D012426:Russia / Q000453:epidemiology; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain