Key result
NT-pro-BNP is not a reliable marker of heart failure in the acute setting for patients with kidney disease, but longitudinal changes may help track volume status.
In patients with kidney disease, NT-pro-BNP is unreliable for acute heart failure diagnosis, highlighting the importance of estimating kidney function before interpretation, though longitudinal changes can help track volume status.
NT-pro-BNP warrants caution for acute HF diagnosis in kidney disease; leaves open whether serial changes reliably track volume status.
The N-terminal pro-brain natriuretic peptide (NT-pro-BNP) is released in response to volume expansion and/or increased tension on cardiac ventricular myocytes. In non-uremic patients, NT-pro-BNP is a useful diagnostic and prognostic biomarker for diagnosis and risk assessment of patients with heart failure. However, impaired kidney function is associated with elevated circulating levels of NT-proBNP. The present review summarizes the literature on NT-pro-BNP in kidney disease, both acute and chronic. We attempt to highlight the importance of estimating kidney function before interpreting an elevated NT-pro-BNP measurement. We also suggest that NT-pro-BNP is not a reliable marker of heart failure in the acute setting, but that longitudinal changes may be of value when tracking volume status in this patient group.
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Axelsson et al. (2010) conducted a review in Kidney disease (acute and chronic). NT-pro-BNP measurement was evaluated. NT-pro-BNP is not a reliable marker of heart failure in the acute setting for patients with kidney disease, but longitudinal changes may help track volume status.
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