Key result
Elevated BNP and copeptin are linked to declining GFR, increased IMT, LVH, and prior CVD.
Why the study?
Are BNP and copeptin levels associated with cardiovascular disease markers in non-dialysis patients with chronic kidney disease?
Observational (n=106)
Are BNP and copeptin levels associated with cardiovascular disease markers in non-dialysis patients with chronic kidney disease?
p-value: p=<0.01
BNP and copeptin levels increase progressively with declining GFR and are independently associated with markers of atherosclerosis and CVD history in non-dialysis CKD patients.
Supports further evaluation of BNP and copeptin in CKD; hypothesis-generating and should not yet alter practice.
BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death in patients with end-stage renal disease (ESRD). We explored the relationship between CVD, plasma brain natriuretic peptide (BNP) and copeptin in non-dialysis patients with chronic kidney disease (CKD). METHODS: BNP and copeptin were measured using ELISA in 86 non-dialysis patients with different degrees of CKD and in 20 control patients. The effects of BNP, copeptin levels and other biochemical indices on carotid ultrasound echocardiography and CVD history were determined using correlation analysis. RESULTS: BNP and copeptin levels were significantly higher in the CKD group than in the control group. Both indices increased progressively, in parallel with the decline in glomerular filtration rate (GFR). BNP levels were (184.25 ± 65.18) ng/L in early phase CKD, (975.245 ± 354.09) ng/L in middle phase CKD, and (1463.51 ± 614.92) ng/ml in end phase CKD compared with levels of (101.56 ± 42.76) ng/L in the control group (all P < 0.01). Copeptin levels in the middle phase ((20.36 ± 9.47) pmol/L) and end phase groups ((54.26 ± 18.23) pmol/L were significantly higher than in the control group ((9.21 ± 2.64) pmol/L; both P < 0.01). There was no difference in copeptin levels between early phase CKD ((10.09 ± 5.23) pmol/L) and control patients. Stepwise multiple regression analysis identified GFR, intima-media thickness (IMT), left ventricular hypertrophy (LVH), and previous history of CVD as independent risk factors for elevated BNP and copeptin levels. CONCLUSION: BNP and copeptin appear to provide sensitive biological markers for the evaluation of atherosclerosis in non-dialysis patients with CKD.
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Li et al. (2013) conducted an observational in Chronic kidney disease (n=106). Elevated BNP and copeptin levels vs. Control patients was evaluated on Association of BNP and copeptin levels with GFR, intima-media thickness, left ventricular hypertrophy, and previous CVD history (p=<0.01). BNP and copeptin levels increased progressively with declining GFR (P<0.01) and were independently associated with intima-media thickness, left ventricular hypertrophy, and previous CVD history.
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