Brain natriuretic peptide levels have diagnostic and prognostic capability for cardio-renal syndrome type 4 in intensive care unit patients View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2009-06

AUTHORS

Sunghoon Park, Goo-Yeong Cho, Sung Gyun Kim, Yong Il Hwang, Hye-Ryun Kang, Seung Hun Jang, Dong-Gyu Kim, Young Rim Song, Young-A Bae, Ki-Suck Jung

ABSTRACT

INTRODUCTION: Limited data are available regarding the diagnostic and prognostic utility of brain natriuretic peptide (BNP) in patients with chronic kidney disease (CKD) in the intensive care unit (ICU) setting. METHODS: All patients with CKD and a serum creatinine (Cr) of 2.0 mg/dl or higher admitted to the ICU between January 2006 and September 2007 were enrolled in this study. The CKD group was divided according to the presence or absence of acute decompensated heart failure (ADHF) into CKD + ADHF and CKD-ADHF groups, respectively. Other patients with ADHF having low Cr (<1.2 mg/dl) in the coronary care unit were also recruited as a control group during the same period. BNP levels at the time of admission (admission BNP) were compared amongst these groups. We then sought to determine whether BNP levels could predict the outcome in patients with CKD. RESULTS: Of 136 patients with CKD for whom data were available, including 58 on dialysis (42.6%), 81 (59.6%) had ADHF and their estimated glomerular filtration rate (eGFR) was 12.8 +/- 7.3 ml/min/1.73 m2. BNP levels at admission were 2708.6 +/- 1246.9, 567.9 +/- 491.7 and 1418.9 +/- 1126.5 pg/ml in the CKD + ADHF, CKD - ADHF and control groups (n = 33), respectively (P = 0.000). The optimal cutoff level in patients with CKD was 1020.5 pg/ml (area under the curve = 0.944) to detect ADHF from the receiver operating characteristic (ROC) curve. This level was not associated with in-hospital mortality, all-cause death or a composite event (all-cause death and/or new cardiac event). However, a borderline significant association was observed with new cardiac events (hazard ratio (HR) = 4.551; P = 0.078) during the follow-up period (521.1 +/- 44.7 days). Furthermore, continuous variables of BNP and BNP quartiles were significantly associated with new cardiac events in the multivariate Cox model (HR = 1.001, P = 0.041; HR = 2.212, P = 0.018). CONCLUSIONS: The findings suggest that the level of BNP at the time of admission may be a useful marker for detecting ADHF and predicting cardiac events in patients with CKD in the ICU setting. More... »

PAGES

r70

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/cc7878

DOI

http://dx.doi.org/10.1186/cc7878

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1005000818

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/19445682


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Turtle is a human-readable linked data format.

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RDF/XML is a standard XML format for linked data.

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297 schema:name Department of Radiology, Hallym University Sacred Heart Hospital, 896, 431-070, Anyang, Kyunggi-do, Republic of Korea
298 Division of Cardiology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, 896, 431-070, Anyang, Kyunggi-do, Republic of Korea
299 Division of Nephrology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, 896, 431-070, Anyang, Kyunggi-do, Republic of Korea
300 Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, 896, 431-070, Anyang, Kyunggi-do, Republic of Korea
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