Circulating BNP and NT-proBNP provide important diagnostic and prognostic information on cardiac dysfunction, hypervolemia, and mortality risk in patients with chronic kidney disease.
Do serial estimations of natriuretic peptides (BNP and NT-proBNP) provide diagnostic and prognostic information in patients with chronic kidney disease and those on renal replacement therapy?
Serial measurement of natriuretic peptides is valuable for risk stratification and identifying complications in patients with chronic kidney disease and those undergoing renal replacement therapy.
Natriuretic peptides play a major role in sodium and body volume homeostasis in patients with adequate kidney function. Circulating B-type natriuretic peptide (BNP) and its amino-terminal fragment NT-proBNP provide important information on cardiac dysfunction, hypervolemia, and risk for hospitalization or death even in patients with severe impairment of kidney function. NT-proBNP acts also as significant independent predictor of progression of chronic kidney disease (CKD). Differences in elimination and degradation as well as molecular weight and half-life between BNP and NT-proBNP are responsible for different plasma levels, different membrane-dependent removal during hemodialysis, and different diagnostic and prognostic power to predict morbidity and mortality in patients at different stages of CKD and in those on hemodialysis or peritoneal dialysis. Serial estimations of natriuretic peptides will help in the identification of potential complications in CKD patients with or without renal replacement therapies and probably improve outcome of these patients.
Khalifeh et al. (2009) conducted a review in Chronic Kidney Disease and Renal Replacement Therapy. Natriuretic peptides (BNP and NT-proBNP) was evaluated. Circulating BNP and NT-proBNP provide important diagnostic and prognostic information on cardiac dysfunction, hypervolemia, and mortality risk in patients with chronic kidney disease.