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NT-proBNP and troponin T and risk of rapid kidney function decline and incident CKD in elderly adults.
Clin J Am Soc Nephrol 2015; 10(2):205-14CJ

Abstract

BACKGROUND AND OBJECTIVES

Elevations in N-terminal pro-B-type natriuretic peptide and high-sensitivity troponin T are associated with poor cardiovascular outcomes. Whether elevations in these cardiac biomarkers are associated with decline in kidney function was evaluated.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS

N-terminal pro-B-type natriuretic peptide and troponin T were measured at baseline in 3752 participants free of heart failure in the Cardiovascular Health Study. eGFR was determined from the Chronic Kidney Disease Epidemiology Collaboration equation using serum cystatin C. Rapid decline in kidney function was defined as decline in serum cystatin C eGFR≥30%, and incident CKD was defined as the onset of serum cystatin C eGFR<60 among those without CKD at baseline (n=2786). Cox regression models were used to examine the associations of each biomarker with kidney function decline adjusting for demographics, baseline serum cystatin C eGFR, diabetes, and other CKD risk factors.

RESULTS

In total, 503 participants had rapid decline in serum cystatin C eGFR over a mean follow-up time of 6.41 (1.81) years, and 685 participants developed incident CKD over a mean follow-up time of 6.41 (1.74) years. Participants in the highest quartile of N-terminal pro-B-type natriuretic peptide (>237 pg/ml) had an 67% higher risk of rapid decline and 38% higher adjusted risk of incident CKD compared with participants in the lowest quartile (adjusted hazard ratio for serum cystatin C eGFR rapid decline, 1.67; 95% confidence interval, 1.25 to 2.23; hazard ratio for incident CKD, 1.38; 95% confidence interval, 1.08 to 1.76). Participants in the highest category of troponin T (>10.58 pg/ml) had 80% greater risk of rapid decline compared with participants in the lowest category (adjusted hazard ratio, 1.80; 95% confidence interval, 1.35 to 2.40). The association of troponin T with incident CKD was not statistically significant (hazard ratio, 1.17; 95% confidence interval, 0.92 to 1.50).

CONCLUSIONS

Elevated N-terminal pro-B-type natriuretic peptide and troponin T are associated with rapid decline of kidney function and incident CKD. Additional studies are needed to evaluate the mechanisms that may explain this association.

Authors+Show Affiliations

Kidney Research Institute, Division of Nephrology, University of Washington, Seattle, Washington; nbansal@nephrology.washington.edu.Kidney Research Institute, Division of Nephrology, University of Washington, Seattle, Washington;Division of Nephrology, University of California, Davis, Sacramento, California;Kidney Research Institute, Division of Nephrology, University of Washington, Seattle, Washington;Divisions of Cardiology and.Kidney Research Institute, Division of Nephrology, University of Washington, Seattle, Washington;Division of Nephrology and.Division of Nephrology, Tufts Medical Center, Boston, Massachusetts; and.Nephrology, University of Maryland, Baltimore, Maryland;Departments of Medicine, Epidemiology, and Biostatistics, University of California, San Francisco, California; Division of General Internal Medicine, San Francisco Veterans Affair Medical Center, San Francisco, California.

Pub Type(s)

Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25605700

Citation

Bansal, Nisha, et al. "NT-proBNP and Troponin T and Risk of Rapid Kidney Function Decline and Incident CKD in Elderly Adults." Clinical Journal of the American Society of Nephrology : CJASN, vol. 10, no. 2, 2015, pp. 205-14.
Bansal N, Katz R, Dalrymple L, et al. NT-proBNP and troponin T and risk of rapid kidney function decline and incident CKD in elderly adults. Clin J Am Soc Nephrol. 2015;10(2):205-14.
Bansal, N., Katz, R., Dalrymple, L., de Boer, I., DeFilippi, C., Kestenbaum, B., ... Shlipak, M. (2015). NT-proBNP and troponin T and risk of rapid kidney function decline and incident CKD in elderly adults. Clinical Journal of the American Society of Nephrology : CJASN, 10(2), pp. 205-14. doi:10.2215/CJN.04910514.
Bansal N, et al. NT-proBNP and Troponin T and Risk of Rapid Kidney Function Decline and Incident CKD in Elderly Adults. Clin J Am Soc Nephrol. 2015 Feb 6;10(2):205-14. PubMed PMID: 25605700.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - NT-proBNP and troponin T and risk of rapid kidney function decline and incident CKD in elderly adults. AU - Bansal,Nisha, AU - Katz,Ronit, AU - Dalrymple,Lorien, AU - de Boer,Ian, AU - DeFilippi,Christopher, AU - Kestenbaum,Bryan, AU - Park,Meyeon, AU - Sarnak,Mark, AU - Seliger,Stephen, AU - Shlipak,Michael, Y1 - 2015/01/20/ PY - 2015/1/22/entrez PY - 2015/1/22/pubmed PY - 2015/10/31/medline KW - CKD KW - epidemiology and outcomes KW - heart disease SP - 205 EP - 14 JF - Clinical journal of the American Society of Nephrology : CJASN JO - Clin J Am Soc Nephrol VL - 10 IS - 2 N2 - BACKGROUND AND OBJECTIVES: Elevations in N-terminal pro-B-type natriuretic peptide and high-sensitivity troponin T are associated with poor cardiovascular outcomes. Whether elevations in these cardiac biomarkers are associated with decline in kidney function was evaluated. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: N-terminal pro-B-type natriuretic peptide and troponin T were measured at baseline in 3752 participants free of heart failure in the Cardiovascular Health Study. eGFR was determined from the Chronic Kidney Disease Epidemiology Collaboration equation using serum cystatin C. Rapid decline in kidney function was defined as decline in serum cystatin C eGFR≥30%, and incident CKD was defined as the onset of serum cystatin C eGFR<60 among those without CKD at baseline (n=2786). Cox regression models were used to examine the associations of each biomarker with kidney function decline adjusting for demographics, baseline serum cystatin C eGFR, diabetes, and other CKD risk factors. RESULTS: In total, 503 participants had rapid decline in serum cystatin C eGFR over a mean follow-up time of 6.41 (1.81) years, and 685 participants developed incident CKD over a mean follow-up time of 6.41 (1.74) years. Participants in the highest quartile of N-terminal pro-B-type natriuretic peptide (>237 pg/ml) had an 67% higher risk of rapid decline and 38% higher adjusted risk of incident CKD compared with participants in the lowest quartile (adjusted hazard ratio for serum cystatin C eGFR rapid decline, 1.67; 95% confidence interval, 1.25 to 2.23; hazard ratio for incident CKD, 1.38; 95% confidence interval, 1.08 to 1.76). Participants in the highest category of troponin T (>10.58 pg/ml) had 80% greater risk of rapid decline compared with participants in the lowest category (adjusted hazard ratio, 1.80; 95% confidence interval, 1.35 to 2.40). The association of troponin T with incident CKD was not statistically significant (hazard ratio, 1.17; 95% confidence interval, 0.92 to 1.50). CONCLUSIONS: Elevated N-terminal pro-B-type natriuretic peptide and troponin T are associated with rapid decline of kidney function and incident CKD. Additional studies are needed to evaluate the mechanisms that may explain this association. SN - 1555-905X UR - https://www.unboundmedicine.com/medline/citation/25605700/NT_proBNP_and_troponin_T_and_risk_of_rapid_kidney_function_decline_and_incident_CKD_in_elderly_adults_ L2 - http://cjasn.asnjournals.org/cgi/pmidlookup?view=long&amp;pmid=25605700 DB - PRIME DP - Unbound Medicine ER -