N-terminal Pro-Brain Natriuretic Peptide Levels Predict Left Ventricular Systolic Function in Patients with Chronic Kidney Disease.
10.3346/jkms.2009.24.S1.S63
- Author:
Jung Eun LEE
1
;
So Yeon CHOI
;
Wooseong HUH
;
Seong Woo PARK
;
Dae Joong KIM
;
Ha Young OH
;
Yoon Goo KIM
Author Information
1. Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. yoongoo.kim@samsung.com
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Biological Markers;
Kidney Failure, Chronic;
Ventricular Dysfunction, Left;
Pro-brain Natriuretic Peptide (1-76)
- MeSH:
Aged;
Area Under Curve;
Female;
Glomerular Filtration Rate;
Humans;
Kidney Failure, Chronic/*complications/pathology;
Male;
Middle Aged;
Natriuretic Peptide, Brain/*blood;
Peptide Fragments/diagnostic use;
Prevalence;
Protein Structure, Tertiary;
Sensitivity and Specificity;
Ventricular Dysfunction, Left/complications/diagnosis;
*Ventricular Function, Left
- From:Journal of Korean Medical Science
2009;24(Suppl 1):S63-S68
- CountryRepublic of Korea
- Language:English
-
Abstract:
N-terminal pro-brain natriuretic peptide (NT-proBNP) can be a useful marker for left ventricular (LV) dysfunction in patients without kidney disease. This study was conducted to clarify the relationship between NT-proBNP and LV systolic function in patients with decreased renal function. We studied 256 chronic kidney disease (CKD) patients, patients on dialysis were excluded. The median glomerular filtration rate was 24 (13-36) mL/min/1.73 m(2) and the median NT-proBNP was 4,849 (1,310- 19,009) pg/mL. The prevalence of LV systolic dysfunction increased from the lower to the upper NT-proBNP quartiles (I, 17%; II, 34%; III, 61%; and IV, 72%; p<0.001 for trend). The NT-proBNP quartile was an independent predictor of LV systolic dysfunction after adjustment for renal function, compared with quartile I: II, odds ratio (OR) 3.99 (95% confidence interval [CI],1.34-11.93); III, OR 11.28 (95% CI, 3.74-33.95); and IV, OR 36.97 (95% CI, 11.47-119.1). Area under the curve and optimum cut points for NT-proBNP to detect LV systolic dysfunction were 0.781 and 2,165 pg/mL in CKD stage 3, 0.812 and 4,740 pg/mL in CKD stage 4, and 0.745 and 15,892 pg/ mL in CKD stage 5. The NT-proBNP level was a predictor of LV systolic dysfunction in CKD patients. Optimum cut points should be stratified according to renal function.
