Key result
Elevated NT-pro-BNP levels in older people must be interpreted in the context of kidney function, as impaired renal function independently increases circulating levels of this biomarker.
When using NT-pro-BNP to diagnose or stage heart failure in older adults, clinicians must account for the patient's kidney function, as renal impairment independently elevates the biomarker.
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Renal adjustment may be needed for NT-proBNP thresholds in older adults; leaves open derivation of eGFR-specific cutoffs in prospective HF studies.
Summary The N-terminal pro-brain natriuretic peptide (NT-pro-BNP) is released in response to volume expansion and/or increased tension on left ventricular myocytes. NT-pro-BNP is a useful diagnostic and prognostic biomarker both in patients with dyspnoea of unknown aetiology, and for risk assessment of patients with established heart failure. However, impaired kidney function – a common condition in older people as well as a strong risk factor for cardiovascular disease is associated with elevated circulating levels of NT-pro-BNP. Therefore, it is important to know the kidney function when interpreting an elevated NT-pro-BNP measurement obtained in older people in order to diagnose or stage congestive heart failure.
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Axelsson et al. (2009) conducted a review in Heart failure. NT-pro-BNP measurement was evaluated. Elevated NT-pro-BNP levels in older people must be interpreted in the context of kidney function, as impaired renal function independently increases circulating levels of this biomarker.
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