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Diagnostic and prognostic value of plasma brain natriuretic peptide in non-dialysis-dependent CRF.
Am J Kidney Dis. 2004 Sep; 44(3):420-8.AJ

Abstract

BACKGROUND

Brain natriuretic peptide (BNP) is useful for the evaluation of ventricular dysfunction in patients with various cardiac diseases. However, its diagnostic value has been considered to be limited in patients with chronic renal failure (CRF) because renal dysfunction itself may affect BNP levels. This study is designed to clarify the diagnostic and prognostic value of plasma BNP level in patients with CRF.

METHODS

In 103 non-dialysis-dependent patients with CRF without heart failure and 60 hypertensive patients with normal renal function, echocardiographic examinations and BNP measurements were performed.

RESULTS

Plasma BNP level was much greater in patients with CRF than in hypertensive controls; however, multiple regression analysis showed that left ventricular (LV) end-diastolic volume (EDV) index (LVEDVI) and the difference in mitral and pulmonary venous atrial wave duration (Ad-PVad), a marker of LV end-diastolic pressure, were independent determinants of plasma BNP levels in patients with CRF. The influence of LV overload (LVEDVI > or = 75 mL/m 2 and/or Ad-PVad < 0 milliseconds) on plasma BNP levels in subjects with CRF was independent of the severity of renal dysfunction. From Kaplan-Meier event-free curves (mean follow-up, 13 months), the incidence of heart failure was much greater in patients with a plasma BNP level of 150 pg/mL or greater (P < 0.001). By means of multivariate Cox regression analysis, high plasma BNP level was the strongest predictor for heart failure events (hazard ratio, 6.31; P < 0.001).

CONCLUSION

These findings support plasma BNP level as a reliable marker of LV overload, even in nondialysis patients with CRF. Also, a high BNP level (> or =150 pg/mL) may have powerful predictive potential for heart failure in these patients.

Authors+Show Affiliations

Department of Medicine, Division of Hypertension and Nephrology, National Cardiovascular Center, Suita, Osaka, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15332214

Citation

Takami, Yoichi, et al. "Diagnostic and Prognostic Value of Plasma Brain Natriuretic Peptide in Non-dialysis-dependent CRF." American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, vol. 44, no. 3, 2004, pp. 420-8.
Takami Y, Horio T, Iwashima Y, et al. Diagnostic and prognostic value of plasma brain natriuretic peptide in non-dialysis-dependent CRF. Am J Kidney Dis. 2004;44(3):420-8.
Takami, Y., Horio, T., Iwashima, Y., Takiuchi, S., Kamide, K., Yoshihara, F., Nakamura, S., Nakahama, H., Inenaga, T., Kangawa, K., & Kawano, Y. (2004). Diagnostic and prognostic value of plasma brain natriuretic peptide in non-dialysis-dependent CRF. American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, 44(3), 420-8.
Takami Y, et al. Diagnostic and Prognostic Value of Plasma Brain Natriuretic Peptide in Non-dialysis-dependent CRF. Am J Kidney Dis. 2004;44(3):420-8. PubMed PMID: 15332214.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnostic and prognostic value of plasma brain natriuretic peptide in non-dialysis-dependent CRF. AU - Takami,Yoichi, AU - Horio,Takeshi, AU - Iwashima,Yoshio, AU - Takiuchi,Shin, AU - Kamide,Kei, AU - Yoshihara,Fumiki, AU - Nakamura,Satoko, AU - Nakahama,Hajime, AU - Inenaga,Takashi, AU - Kangawa,Kenji, AU - Kawano,Yuhei, PY - 2004/8/28/pubmed PY - 2005/2/24/medline PY - 2004/8/28/entrez SP - 420 EP - 8 JF - American journal of kidney diseases : the official journal of the National Kidney Foundation JO - Am. J. Kidney Dis. VL - 44 IS - 3 N2 - BACKGROUND: Brain natriuretic peptide (BNP) is useful for the evaluation of ventricular dysfunction in patients with various cardiac diseases. However, its diagnostic value has been considered to be limited in patients with chronic renal failure (CRF) because renal dysfunction itself may affect BNP levels. This study is designed to clarify the diagnostic and prognostic value of plasma BNP level in patients with CRF. METHODS: In 103 non-dialysis-dependent patients with CRF without heart failure and 60 hypertensive patients with normal renal function, echocardiographic examinations and BNP measurements were performed. RESULTS: Plasma BNP level was much greater in patients with CRF than in hypertensive controls; however, multiple regression analysis showed that left ventricular (LV) end-diastolic volume (EDV) index (LVEDVI) and the difference in mitral and pulmonary venous atrial wave duration (Ad-PVad), a marker of LV end-diastolic pressure, were independent determinants of plasma BNP levels in patients with CRF. The influence of LV overload (LVEDVI > or = 75 mL/m 2 and/or Ad-PVad < 0 milliseconds) on plasma BNP levels in subjects with CRF was independent of the severity of renal dysfunction. From Kaplan-Meier event-free curves (mean follow-up, 13 months), the incidence of heart failure was much greater in patients with a plasma BNP level of 150 pg/mL or greater (P < 0.001). By means of multivariate Cox regression analysis, high plasma BNP level was the strongest predictor for heart failure events (hazard ratio, 6.31; P < 0.001). CONCLUSION: These findings support plasma BNP level as a reliable marker of LV overload, even in nondialysis patients with CRF. Also, a high BNP level (> or =150 pg/mL) may have powerful predictive potential for heart failure in these patients. SN - 1523-6838 UR - https://www.unboundmedicine.com/medline/citation/15332214/Diagnostic_and_prognostic_value_of_plasma_brain_natriuretic_peptide_in_non_dialysis_dependent_CRF_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0272638604008121 DB - PRIME DP - Unbound Medicine ER -