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Prognostic potential of brain natriuretic peptide (BNP) in predialysis chronic kidney disease patients.
Clin Sci (Lond). 2005 Jul; 109(1):75-82.CS

Abstract

In the present study, we investigated the potential of N-BNP (N-terminal B-type natriuretic peptide) as a prognostic marker for risk of CV (cardiovascular) events, overall mortality and progression to ESRD (end-stage renal disease) in a cohort of 83 pre-dialysis CKD (chronic kidney disease) patients without clinical evidence of heart failure. During the study, ten patients reached the combined end point of overall mortality and/or CV event. Univariate factors associated with the combined end point were plasma N-BNP (P < 0.0005), creatinine (P < 0.002), systolic blood pressure (P < 0.009) and age (P < 0.015). N-BNP levels were higher in patients with CV events (P < 0.0005). Cox model regression analysis yielded log10 N-BNP (hazard ratio, 9.608; P < 0.007) and pre-existing CV disease (hazard ratio, 4.571; P < 0.029) as independent predictors of overall mortality or CV events. Kaplan-Meier analysis curves for the subgroup with supramedian creatinine levels (225 micromol/l) showed significant separation of the curves stratified for plasma N-BNP levels above and below the group median (291 pmol/l) for all end points. Receiver-operator-characteristic curves for N-BNP (355 pmol/l cut-off) demonstrated a specificity of 65.8% at a sensitivity of 100% for predicting CV events/overall mortality. The measurement of plasma N-BNP may aid in the risk stratification of pre-dialysis CKD patients. The high sensitivity and negative predictive value (100%) may enable the selection of patients who could safely be excluded from further investigations, resulting in better focusing of resources.

Authors+Show Affiliations

Department of Nephrology, University Hospital of Leicester, Leicester General Hospital, Gwendolen Road, Leicester LE5 4PW, UK. Sue.Carr@uhl-tr.nhs.ukNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15743271

Citation

Carr, Susan J., et al. "Prognostic Potential of Brain Natriuretic Peptide (BNP) in Predialysis Chronic Kidney Disease Patients." Clinical Science (London, England : 1979), vol. 109, no. 1, 2005, pp. 75-82.
Carr SJ, Bavanandan S, Fentum B, et al. Prognostic potential of brain natriuretic peptide (BNP) in predialysis chronic kidney disease patients. Clin Sci. 2005;109(1):75-82.
Carr, S. J., Bavanandan, S., Fentum, B., & Ng, L. (2005). Prognostic potential of brain natriuretic peptide (BNP) in predialysis chronic kidney disease patients. Clinical Science (London, England : 1979), 109(1), 75-82.
Carr SJ, et al. Prognostic Potential of Brain Natriuretic Peptide (BNP) in Predialysis Chronic Kidney Disease Patients. Clin Sci. 2005;109(1):75-82. PubMed PMID: 15743271.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prognostic potential of brain natriuretic peptide (BNP) in predialysis chronic kidney disease patients. AU - Carr,Susan J, AU - Bavanandan,Sunita, AU - Fentum,Barbara, AU - Ng,Leong, PY - 2005/3/4/pubmed PY - 2005/7/30/medline PY - 2005/3/4/entrez SP - 75 EP - 82 JF - Clinical science (London, England : 1979) JO - Clin. Sci. VL - 109 IS - 1 N2 - In the present study, we investigated the potential of N-BNP (N-terminal B-type natriuretic peptide) as a prognostic marker for risk of CV (cardiovascular) events, overall mortality and progression to ESRD (end-stage renal disease) in a cohort of 83 pre-dialysis CKD (chronic kidney disease) patients without clinical evidence of heart failure. During the study, ten patients reached the combined end point of overall mortality and/or CV event. Univariate factors associated with the combined end point were plasma N-BNP (P < 0.0005), creatinine (P < 0.002), systolic blood pressure (P < 0.009) and age (P < 0.015). N-BNP levels were higher in patients with CV events (P < 0.0005). Cox model regression analysis yielded log10 N-BNP (hazard ratio, 9.608; P < 0.007) and pre-existing CV disease (hazard ratio, 4.571; P < 0.029) as independent predictors of overall mortality or CV events. Kaplan-Meier analysis curves for the subgroup with supramedian creatinine levels (225 micromol/l) showed significant separation of the curves stratified for plasma N-BNP levels above and below the group median (291 pmol/l) for all end points. Receiver-operator-characteristic curves for N-BNP (355 pmol/l cut-off) demonstrated a specificity of 65.8% at a sensitivity of 100% for predicting CV events/overall mortality. The measurement of plasma N-BNP may aid in the risk stratification of pre-dialysis CKD patients. The high sensitivity and negative predictive value (100%) may enable the selection of patients who could safely be excluded from further investigations, resulting in better focusing of resources. SN - 0143-5221 UR - https://www.unboundmedicine.com/medline/citation/15743271/Prognostic_potential_of_brain_natriuretic_peptide__BNP__in_predialysis_chronic_kidney_disease_patients_ L2 - https://portlandpress.com/clinsci/article-lookup/doi/10.1042/CS20040351 DB - PRIME DP - Unbound Medicine ER -