Natriuretic peptides for early prediction of acute kidney injury in community-acquired pneumonia

Nowak, Albina; Breidthardt, Tobias; Dejung, Sarah; Bingisser, Roland; Drexler, Beatrice; Meune, Christophe; Marono, David; Mosimann, Tamina; Müller, Beat; Müller, Christian

doi:10.1016/j.cca.2013.01.014

Cited by 18 publications

(11 citation statements)

References 39 publications

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“…The NT-pro-BNP predictive accuracy for CIN as defined by various definitions in our study (CIN 0.5 : AUC = 0.754, 95% CI = 0.73–0.79, P < 0.001) was similar to that reported in recent study about investigating NT-pro-BNP for early prediction of acute kidney injury (AKI) in community-acquired pneumonia. 24 Furthermore, the predictive value of NT-pro-BNP for CIN is similar to the classic Mehran CIN score ( P = 0.508). However, Mehran risk score includes many procedural factors, such as the type and volume of CM, and are not convenient in clinical practice and could not be used to evaluate the risk of CIN before PCI.…”

Section: Discussionmentioning

confidence: 70%

Association of N-Terminal Pro-B-Type Natriuretic Peptide With Contrast-Induced Nephropathy and Long-Term Outcomes in Patients With Chronic Kidney Disease and Relative Preserved Left Ventricular Function

Liu

Zhou³

et al. 2015

Medicine

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The aim of the present article was to evaluate the association of N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) with contrast-induced nephropathy (CIN) and long-term outcomes in patients with chronic kidney disease (CKD) and relative preserved left ventricular function (LVF) undergoing percutaneous coronary intervention (PCI).We prospectively enrolled 1203 consecutive patients with CKD and preserved LVF undergoing elective PCI. The primary end point was the development of CIN, defined as an absolute increase in serum creatinine (SCr) ≥0.5 mg/dL, from baseline within 48 to 72 hours after contrast medium exposure.CIN incidence varied from 2.2% to 5.2%. Univariate logistic analysis showed that lg-NT-pro-BNP was significantly associated with CIN (odds ratio [OR] = 3.93, 95% confidence interval [CI], 2.22–6.97, P < 0.001). Furthermore, lg-NT-pro-BNP remained a significant predictor of CIN (OR = 3.30, 95% CI, 1.57–6.93, P = 0.002), even after adjusting for potential confounding risk factors. These results were confirmed by using other CIN criteria, which were defined as elevations of the SCr by 25% or 0.5 and 0.3 mg/dL from the baseline. The best cutoff value of lg-NT-pro-BNP for detecting CIN was 2.73 pg/mL (537 pg/mL) with 73.1% sensitivity and 70.0% specificity according to the receiver operating characteristic (ROC) analysis (C statistic = 0.754, 95% CI, 0.67–0.84, P < 0.001). In addition, NT-pro-BNP ≥537 pg/mL (2.73 pg/mL, lg-NT-pro-BNP) was associated with an increased risk of all-cause mortality and composite end points during 2.5 years of follow-up.NT-pro-BNP ≥537 pg/mL is independently associated with an increased risk of CIN with different definitions and poor clinical outcomes in patients with CKD and relative preserved LVF undergoing PCI.

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Section: Discussionmentioning

confidence: 70%

Association of N-Terminal Pro-B-Type Natriuretic Peptide With Contrast-Induced Nephropathy and Long-Term Outcomes in Patients With Chronic Kidney Disease and Relative Preserved Left Ventricular Function

Liu

Zhou³

et al. 2015

Medicine

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“…Так, наличие ОПП у критических пациентов, не имевших на момент поступления ОДХСН, ассоциировано с более высоким уровнем BNP [40]. Установлено, что повышение уровня натрийуретического пептида у реанимационных больных в первые сутки госпитализации достоверно связано с ри-ском развития ОПП и смертностью [41]. Как BNP, так и NT-proBNP позволяют прогнозировать ОПП у пациентов с внебольничной пневмонией [42].…”

Section: Discussionunclassified

Value of N-terminal pro brain natriuretic peptide in predicting acute kidney injury in patients with acute decompensated chronic heart failure

Menzorov

Shutov

Мидленко

et al. 2017

Terapevticheskii arkhiv

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Значение N-концевого предшественника мозгового натрийуретического пептида в прогнозировании острого повреждения почек у больных с острой декомпенсацией хронической сердечной недостаточности М.В. МЕНЗОРОВ, А.М. ШУТОВ, В.И. МИДЛЕНКО, Н.В. ЛАРИОНОВА, И.В. МОРОЗОВА, О.В. АКУЛОВА ФГБОУ ВПО «Ульяновский государственный университет», Ульяновск, Россия Резюме Цель исследования. Изучить прогностическое значение N-концевого предшественника мозгового натрийуретического пептида (NT-proBNP) сыворотки крови в развитии острого повреждения почек (ОПП) у больных с острой декомпенсацией хронической сердечной недостаточности (ОДХСН). Материалы и методы. Обследовали 83 больных с ОДХСН -55 (66%) мужчин и 28 (34%) женщин, средний возраст соста-вил 65±11 лет. ОПП диагностировали и классифицировали согласно Рекомендациям KDIGO (2012). Чтобы исключить индуцированное контрастным веществом ОПП, в исследование включили только пациентов, которым во время госпита-лизации и за 7 дней до нее не вводились рентгеноконтрастные препараты. У всех пациентов при поступлении в стационар определяли концентрацию NT-proBNP в сыворотке крови иммуноферментным методом. Результаты. ОПП диагностировано у 18 (22%) больных, причем у 13 (16%) I стадию, 4 (5%) II стадию, 1 (1%) III стадию ОПП. Концентрация NT-proBNP в сыворотке крови была достоверно выше у больных с ОПП по сравнению с остальными пациентами -1512,1 (981,0; 2246,2) и 861,8 (499,0; 1383,6) пг/мл (p=0,008). Установлено, что концентрация NT-proBNP более 942 пг/мл ассоциирована со значительным ростом риска развития ОПП (относительный риск -ОР 4,3 при 95% доверительном интервале -ДИ от 1,27 до 14,90; p=0,02). По данным RОС-анализа, уровень NT-proBNP >942 пг/мл позволяет прогнозировать ОПП с чувствительностью 78 (52; 94) % и специфичностью 55 (44; 69) % (AUC=0,70; р=0,006). В стационаре умерли 4 (5%) больных. У всех умерших уровень NT-proBNP превышал 942 пг/мл. У 2 из 4 умерших больных имелось ОПП. Заключение. Высокий уровень NT-proBNP во время госпитализации больного ОДХСН может служить биомаркером высо-кого риска развития ОПП и высокой летальности. Aim. To investigate the prognostic value of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) in the development of acute kidney injury (AKI) in patients with acute decompensated chronic heart failure (ADCHF). Subjects and methods. Eighty-three patients (55 (66%) men and 28 (34%) women; mean age, 65±11 years) with ADCHF were examined. AKI was diagnosed and classified according to the 2012 Kidney Disease Improving Global Outcomes Clinical Practice guidelines. To rule out contrast-induced AKI, the investigation enrolled only patients in whom radiopague agents had not been injected 7 days before and during hospitalization. Enzyme immunoassay was used to determine serum NT-proBNP concentrations in all the patients upon hospital admission. Results. AKI was diagnosed in 18 (22%) patients, 13 (16%) had Stage I, 4 (5%) had Stage II, and 1 (1%) had Stage III. The serum concentration of NT-proBNP was significantly higher in patients with AKI than that in the ...

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“…6,7 Few studies coming out in the last few years showed a good prognostic power of BNP to predict severity and prognosis of pneumonia. [8][9][10][11][12] Patients with pneumonia frequently face hypoxemia or respiratory failure which can be just part of the more complex SIRS and which can affect heart function. NTproBNP is synthesized in myocytes from the ventricles in relation to the severity of ventricular dysfunction and promotes the renal excretion of sodium (natriuresis) and water (diuresis), causes vasodilatation by relaxing vascular smooth muscle cells, improves diastolic relaxation (lusitropy) and decreases myocardial fibrosis.…”

Section: Discussionmentioning

confidence: 99%

NT-proBNP correlates with the illness scores pneumonia severity index and CURB-65 in patients with pneumonia

et al. 2017

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Pneumonia severity index (PSI) and urea, respiratory rate, blood pressure, age ≥65) are used to estimate the severity and prognosis of patients with pneumonia. NT-proBNP is a marker of myocardial stress and of sepsis-induced myocardial depression and might be used to predict short and long-term survival in patients with pneumonia. Twenty-three patients [age 79±15 standard deviation (SD); M/F 8/15, CURB-65 2.2±0.9 SD, PSI 118±38 SD, procalcitonin 3.9±5 SD] with pneumonia hospitalized in our Internal Medicine Unit were retrospectively evaluated. NT-proBNP was measured in the first 72 h of hospitalization. CURB-65 and PSI were calculated and correlation with biomarkers investigated. NT-proBNP showed a moderate statistically significant correlation with both PSI and CURB-65 (NT-proBNP vs PSI, r=0.42, P<0.05, NT-proBNP vs CURB-65, r=0.46, P<0.05). These correlations were confirmed also when patients with a diagnosis of heart failure where excluded from the analysis, even if the correlation did not reach the statistical significance. NT-proBNP seems to well correlate with the illness scores PSI and CURB-65 and might be a reliable predictor of severity and survival in patients with pneumonia.

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Natriuretic peptides for early prediction of acute kidney injury in community-acquired pneumonia

Cited by 18 publications

References 39 publications

Association of N-Terminal Pro-B-Type Natriuretic Peptide With Contrast-Induced Nephropathy and Long-Term Outcomes in Patients With Chronic Kidney Disease and Relative Preserved Left Ventricular Function

Association of N-Terminal Pro-B-Type Natriuretic Peptide With Contrast-Induced Nephropathy and Long-Term Outcomes in Patients With Chronic Kidney Disease and Relative Preserved Left Ventricular Function

Value of N-terminal pro brain natriuretic peptide in predicting acute kidney injury in patients with acute decompensated chronic heart failure

NT-proBNP correlates with the illness scores pneumonia severity index and CURB-65 in patients with pneumonia

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