Effect of renal failure on N-terminal Pro-Brain natriuretic peptide in patients admitted to emergency department with acute dyspnea

Preexisting renal failure diminishes the excretion of N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP), therefore limits the diagnostic value of this peptide for concomitant heart failure. The aim of this study was to evaluate the association between NT-proBNP and the stages of renal dysfunction...

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Published in:Anadolu kardiyoloji dergisi : AKD 2014-09, Vol.14 (6), p.519-524
Main Authors: Colak, Ayfer, Cuhadar, Serap, Golcuk, Burcu, Golcuk, Yalcin, Ozdogan, Oner, Coker, Isil
Format: Article
Language:English
Subjects:
Biomarkers - blood
Cross-Sectional Studies
Dyspnea - etiology
Echocardiography
Emergency Service, Hospital
Female
Heart Failure - blood
Heart Failure - complications
Heart Failure - diagnosis
Heart Failure - diagnostic imaging
Humans
Male
Natriuretic Peptide, Brain - blood
Patient Admission
Peptide Fragments - blood
Predictive Value of Tests
Renal Insufficiency - blood
Renal Insufficiency - complications
ROC Curve
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Summary:Preexisting renal failure diminishes the excretion of N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP), therefore limits the diagnostic value of this peptide for concomitant heart failure. The aim of this study was to evaluate the association between NT-proBNP and the stages of renal dysfunction in a typical population attended to emergency department with acute dyspnea. In this cross-sectional study, all consecutive patients with acute dyspnea underwent clinical evaluation, laboratory assessment of NT-proBNP, and echocardiographic examinations. Among subjects, 54.5% were diagnosed as heart failure. Grouping variables according to renal function capacity and ejection fraction, independent variables were compared with Kruskal-Wallis or ANOVA with posthoc tests. Correlation and linear regression analysis were done to analyze the variables associated with NT-proBNP. The diagnostic performance of NT-proBNP was evaluated by receiver-operating characteristic (ROC) curve. Serum median NT-proBNP level in patients with severe renal impairment was significantly higher than moderate and mildly decreased renal functions (p=0.001). In patients with moderate and severe left ventricular failure, NT-proBNP was significantly higher compared with normal subjects (LVEF>50%) (p=0.040, and 0.017, respectively). Renal dysfunction was associated in 56% of patients with heart failure. The area under the ROC curve of NT-proBNP for identifying left ventricular failure in patients with renal failure (eGFR
ISSN:1302-8723
2149-2263
1308-0032
2149-2271
DOI:10.5152/akd.2014.4944