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5/6th Nephrectomy in Combination with High Salt Diet and Nitric Oxide Synthase Inhibition to Induce Chronic Kidney Disease in the Lewis Rat
Published on: July 3, 2013
Natriuretic peptides in chronic kidney disease
Rajat Tagore1, Lieng H Ling, Hong Yang
1Division of Nephrology, Department of Medicine, National University Hospital, Singapore. Rajat_Tagore@nuhs.edu.sg
Summary
Plasma BNP levels are independent of kidney function, unlike NT-proBNP. This suggests BNP is a more reliable biomarker for screening cardiac dysfunction in chronic kidney disease (CKD) patients.
Area of Science:
- Cardiology
- Nephrology
- Biomarker Research
Background:
- Cardiovascular disease is prevalent in chronic kidney disease (CKD) patients.
- B-type natriuretic peptide (BNP) and NT-proBNP are key biomarkers for cardiovascular disease.
- Conflicting data exists regarding the influence of glomerular filtration rate (GFR) on these biomarkers in CKD.
Purpose of the Study:
- To compare plasma BNP and NT-proBNP levels in ambulatory, euvolemic CKD patients.
- To investigate the influence of GFR on BNP and NT-proBNP, accounting for cardiac function.
- To determine the more appropriate biomarker for cardiac dysfunction screening in CKD.
Main Methods:
- Prospective head-to-head comparison of BNP and NT-proBNP in 142 CKD patients.
- GFR estimated using the Modification of Diet in Renal Disease formula.
- Cardiac morphology and function assessed by echocardiography; BNP/NT-proBNP measured via specific assays.
Main Results:
- In CKD patients (mean GFR 38 ml/min), NT-proBNP was predicted by GFR, LV mass index, and hemoglobin; BNP was predicted by LV mass index and beta-blocker usage.
- Plasma BNP levels were independent of GFR.
- NT-proBNP levels increased significantly as GFR declined in patients without diastolic dysfunction, while BNP levels did not.
Conclusions:
- Plasma BNP levels are relatively independent of GFR in CKD patients.
- NT-proBNP levels are significantly influenced by GFR.
- BNP is suggested as a more appropriate biomarker for screening cardiac dysfunction in CKD.
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