• Manabu Horii, Takaki Matsumoto, Shiro Uemura, Yu Sugawara, Akihiro Takitsume, Tomoya Ueda, Hitoshi Nakagawa, Taku Nishida, Tsunenari Soeda, Satoshi Okayama, Satoshi Somekawa, Kenichi Ishigami, Yukiji Takeda, Hiroyuki Kawata, Rika Kawakami, and Yoshihiko Saito.
• First Department of Internal Medicine, Nara Medical University, Kashihara, Japan.
• J Cardiol. 2013 Jun 1;61(6):410-6.

BackgroundBrain natriuretic peptide (BNP) and amino-terminal proBNP (NT-proBNP) are useful biomarkers for diagnosis and prediction of prognosis. Both of these peptides are elevated in patients with chronic kidney disease (CKD), but there is no evidence as to which peptide is the more suitable biomarker in patients with severe renal dysfunction.Methods And ResultsThis retrospective cohort study evaluated patients with cardiovascular diseases (64.9±11.7 years, mean±SD). The end points were all-cause death and a composite end point of all-cause death, nonfatal myocardial infarction, nonfatal stroke, hospitalization for severe heart failure, and initiation of hemodialysis. Baseline plasma BNP and NT-proBNP levels, expressed as log-transformed data, were closely correlated in patients with CKD stages 1-3 (n=998) (r2=0.870, p<0.001), whereas for CKD stages 4-5 (n=85) there was a significant but weaker correlation (r2=0.209, p<0.001). During follow-up periods (51.3±0.4 months), 132 patients died and 202 patients reached the composite end point. The area under the receiver operating characteristic curve (AUROC) for BNP and NT-proBNP were similar for CKD stages 1-3. However, for CKD stages 4-5, the AUC for mortality for BNP was 0.713 and that for NT-proBNP was 0.760, while the AUC for the composite end point for BNP was 0.666 and that for NT-proBNP was 0.720.ConclusionsBoth BNP and NT-proBNP are useful biomarkers for mortality and cardiovascular events, but NT-proBNP may be superior to BNP for CKD stages 4-5.Copyright © 2013 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

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