The role of NT-proBNP in chronic heart failure and renal insufficiency

Rothenburger, Markus; Stypmann, Joerg; Wichter, Thomas; Löher, Andreas; Berendes, Elmer; Röttger, Carina; Etz, Christian D.; Schmid, C; Scheld, H.H.

doi:10.1055/s-2005-862012

Cited by 1 publication

(2 citation statements)

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“…Efficient and timely diagnosis is critical for reducing the mortality rates (35). NT-proBNP has long been used as a routine and rapid diagnostic method for patients with AHF (7-9); however, the use of NT-proBNP in diagnosing AHF in patients with renal insufficiency is controversial, since its level is markedly affected by the renal function (13)(14)(15)35). A significant proportion of patients exhibit functional impairment of both the heart and kidneys (36,37).…”

Section: Discussionmentioning

confidence: 99%

“…In addition, patients with chronic kidney disease (CKD) present increased risks of accelerated atherosclerosis, nonfatal myocardial infarction, congestive heart failure (CHF), atrial and ventricular arrhythmias, and cardiac death (11). Although NT-proBNP is considered as a marker in AHF diagnosis, the diagnostic value of NT-proBNP in patients with renal insufficiency is still debated (12)(13)(14)(15). Therefore, a more effective plasma marker is required for the diagnosis of AHF patients with renal insufficiency.…”

Section: Introductionmentioning

confidence: 99%

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Adiponectin is valuable in the diagnosis of acute heart failure with renal insufficiency

Zhang

et al. 2018

Exp Ther Med

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Acute heart failure (AHF) is a major public health issue due to its high incidence and poor prognosis; thus, efficient and timely diagnosis is critical for improving the prognosis and lowering the mortality rate. Amino-terminal pro-brain natriuretic peptide (NT-proBNP) is widely used in the diagnosis of AHF; however, its efficacy is controversial in diagnosing AHF with renal insufficiency. There were numerous studies reporting the association of adiponectin (ADPN) and heart diseases. Therefore, the present study aimed to investigate whether ADPN is helpful in identifying AHF with renal insufficiency. A total of 407 participants (218 AHF patients and 189 controls) were enrolled into the current study. The plasma levels of ADPN and NT-proBNP were measured using a sandwich enzyme-linked immunosorbent assay and an electrochemiluminescence immunoassay, respectively. In addition, these levels were compared among the various New York Health Association classes, as well as the ischemic and non-ischemic AHF cases. The correlation between the two biomarkers and the renal function was analyzed by Spearman's correlation, while the diagnostic efficiency of ADPN and NT-proBNP was evaluated in AHF patients with and without renal insufficiency. The results revealed that NT-proBNP exhibited a higher diagnostic efficiency as compared with ADPN in patients without renal insufficiency [area under the receiver operating characteristic curve (AUC), 0.905 vs. 0.775]. By contrast, the ADPN presented a better diagnostic value in comparison with NT-proBNP in AHF with renal insufficiency (AUC, 0.872 vs. 0.828). Therefore, a combination of these two biomarkers may provide an excellent efficacy in the diagnosis of AHF with renal insufficiency (AUC, 0.904; sensitivity, 71.2%; specificity, 98.3%). In conclusion, ADPN is a valuable biomarker for diagnosing AHF, particularly in patients with impaired renal function.

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