Key result
Lower GFR and hematocrit, and higher systolic blood pressure and protein:creatinine ratio were significantly associated with higher NT-proBNP levels in African Americans with hypertensive CKD.
Cross-Sectional (n=982)
Effect estimate: GFR r = -0.39; hematocrit r = -0.21; SBP r = 0.30; log UPCR r = 0.32
p-value: p=<0.001
In African Americans with hypertensive CKD without clinical heart failure, lower GFR and hematocrit, and higher systolic blood pressure and proteinuria are associated with elevated NT-proBNP, suggesting a role of volume expansion in increasing heart failure risk.
Should not yet change NT-proBNP thresholds in hypertensive CKD; hypothesis-generating for volume expansion in heart failure risk.
BACKGROUND/AIMS: The N-amino-terminal fragment of the prohormone B-type natriuretic peptide (NT-proBNP) is a marker of cardiac stress and elevated levels are indicative of heart failure. Few correlates of NT-proBNP levels have been identified in persons with moderate chronic kidney disease (CKD), and data from those without heart failure and from African Americans are especially limited. METHODS: The African American Study of Kidney Disease and Hypertension (AASK) enrolled nondiabetic African Americans with hypertensive kidney disease (glomerular filtration rate [GFR] = 20-65 ml/min/1.73 m(2)) and no evidence of clinical heart failure. NT-proBNP was measured in 982 AASK participants. RESULTS: In unadjusted analyses, GFR (r = -0.39; p < 0.001), hematocrit (r = -0.21; p < 0.001) and body mass index (BMI; r = -0.07; p = 0.04) were inversely correlated, and systolic blood pressure (r = 0.30; p < 0.001) and log UPCR (r = 0.32; p < 0.001) were positively correlated with log NT-proBNP levels. After adjustment for potential confounders, lower GFR and hematocrit and higher systolic blood pressure and protein:creatinine ratio remained significantly associated with higher NT-proBNP. CONCLUSION: Lower GFR and hematocrit, and higher urinary protein excretion may be associated with volume expansion in CKD. These results suggest that these processes are associated with increased NT-proBNP in CKD and may play a role in the development of heart failure.
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Yi et al. (2008) conducted a cross-sectional in Hypertensive chronic kidney disease (n=982). Clinical and laboratory parameters (GFR, hematocrit, systolic blood pressure, protein:creatinine ratio) was evaluated on log NT-proBNP levels (GFR r = -0.39; hematocrit r = -0.21; SBP r = 0.30; log UPCR r = 0.32, p=<0.001). Lower GFR and hematocrit, and higher systolic blood pressure and protein:creatinine ratio were significantly associated with higher NT-proBNP levels in African Americans with hypertensive CKD.
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