Key result
An NT-proBNP cutoff of ~3700 pg/ml detects ADHF in volume-overloaded CKD patients with high LVFP.
Why the study?
Diagnosing ADHF in CKD patients is complex because interpreting NT-proBNP in this setting is complicated, prompting the need to determine an NT-proBNP cutoff.
What is the diagnostic cutoff of NT-proBNP for acute decompensated heart failure in patients with chronic kidney disease?
Cross-Sectional (n=85)
No
What is the diagnostic cutoff of NT-proBNP for acute decompensated heart failure in patients with chronic kidney disease?
The diagnostic cutoff for NT-proBNP in acute decompensated heart failure is significantly elevated (3737 pg/ml) in patients with concurrent chronic kidney disease and high left ventricular filling pressures.
Suggests standard NT-proBNP thresholds may lead to overdiagnosis in.
BackgroundThe diagnosis of Acute Decompensated Heart Failure (ADHF) in Chronic Kidney Disease(CKD) patients is complex, NT-pro BNP interpretation in such a setting is complicated. The aim of this study is to determine the cutoff for NT-proBNP in CKD patients with ADHF. Methods: In this retrospective, cross-sectional study, 85 hospitalized patients were evaluated, 66 had CKD. All patients had clinical evidence of volume overload. NT-proBNP and eGFR were assessed in all patients. Left Ventricular Filling Pressure (LVFP) was measured to confirm the diagnosis of ADHF. Results: NT-proBNP was higher in volume overloaded patients with age more than 75 years as compared to those less than 75 years. NT-proBNP was higher in patients with CKD compared to non CKD patients. NT-proBNP progressively increased according to the CKD stage. The cutoff of NT- proBNP in patients with clinical evidence of volume overload and CKD was 1750 pg/ml and 2760 pg/ml in patients with high LVFP. In CKD patients with clinical volume overload and a high LVFP the NT-proBNP cutoff value was 3737pg/ml. There was a positive correlation of NT-BNP with LVFP and diastolic dysfunction. Conclusion: NT-proBNP has utility for the diagnosis of ADHF. It is higher in the CKD population and rises progressively with CKD stages. The cutoff for the diagnosis of ADHF in CKD patients is 3737 pg/ml in the setting of confirmed evidence of ADHF with a high LVFP.
No takes yet. Share an insight, caveat, or question.
Mansur et al. (2021) conducted a cross-sectional in Acute Decompensated Heart Failure and Chronic Kidney Disease (n=85). NT-proBNP and Left Ventricular Filling Pressure assessment vs. Non-CKD patients or normal LVFP was evaluated on Diagnostic accuracy (AUC) of NT-proBNP for ADHF in CKD patients with high LVFP and volume overload (AUC 0.77, 95% CI 0.67-0.86, p=<0.01). In CKD patients with clinical volume overload and high left ventricular filling pressure, an NT-proBNP cutoff of 3737 pg/ml provided a sensitivity of 69% and specificity of 70% for diagnosing ADHF.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: