PMID- 19920165
OWN - NLM
STAT- MEDLINE
DCOM- 20100614
LR  - 20211020
IS  - 1554-6179 (Electronic)
IS  - 1539-4182 (Print)
IS  - 1539-4182 (Linking)
VI  - 8
IP  - 1
DP  - 2010 Mar
TI  - Association of B-type natriuretic Peptide levels with estimated glomerular 
      filtration rate and congestive heart failure.
PG  - 7-12
LID - 10.3121/cmr.2009.867 [doi]
AB  - BACKGROUND: The causes of elevated B-Type natriuretic peptide (BNP) levels are 
      multifactorial. Renal dysfunction has been shown to affect BNP levels in some 
      studies and the diagnostic value of BNP levels in the presence of chronic kidney 
      disease has been questioned. Prior studies have involved small patient 
      populations with variable outcomes noted. This study evaluated the association of 
      BNP levels with an estimated glomerular filtration rate (eGFR) and presence or 
      absence of congestive heart failure (CHF). METHODS: A retrospective, 
      cross-sectional study in which medical records were electronically screened, 
      identified patients with a BNP level and serum creatinine measurement on the same 
      day between December 2002 and March 2006. RESULTS: Of 1739 eligible patients, 537 
      were positive for CHF and 1202 were negative for CHF by our criteria. There was a 
      clear trend for BNP to be higher with the advancement of CHF, as determined by 
      New York Heart Association (NYHA) classification (P<0.001). Median BNP levels 
      increased from 65 pg/mL in patients without CHF to 496 pg/mL in patients with 
      NYHA class IV CHF (P <0.001), and there was a strong inverse association with 
      eGFR (P <0.001). CONCLUSION: BNP levels show a strong inverse association with 
      eGFR in both CHF and non-CHF patients. Currently best practice at most 
      institutions involves use of BNP cutoff diagnostic levels not adjusted for eGFR. 
      The data presented underlines that eGFR is a significant confounder of BNP 
      measurement especially when renal status is compromised and interpretation of 
      clinical significance in the presence of elevated BNP measures should take renal 
      status into consideration.
FAU - Wiley, Carmen L
AU  - Wiley CL
AD  - Providence Sacred Heart Medical Center, Laboratory Medicine and Pathology, 
      Spokane, WA, USA. carmen.wiley@providence.org
FAU - Switzer, Sean P
AU  - Switzer SP
FAU - Berg, Richard L
AU  - Berg RL
FAU - Glurich, Ingrid
AU  - Glurich I
FAU - Dart, Richard A
AU  - Dart RA
LA  - eng
PT  - Journal Article
DEP - 20091117
PL  - United States
TA  - Clin Med Res
JT  - Clinical medicine & research
JID - 101175887
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
RN  - AYI8EX34EU (Creatinine)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Creatinine/blood
MH  - Cross-Sectional Studies
MH  - Female
MH  - *Glomerular Filtration Rate
MH  - Heart Failure/*blood/pathology
MH  - Humans
MH  - Kidney/metabolism/pathology
MH  - Male
MH  - Middle Aged
MH  - Natriuretic Peptide, Brain/*blood
MH  - Retrospective Studies
PMC - PMC2842335
EDAT- 2009/11/19 06:00
MHDA- 2010/06/15 06:00
PMCR- 2010/03/01
CRDT- 2009/11/19 06:00
PHST- 2009/11/19 06:00 [entrez]
PHST- 2009/11/19 06:00 [pubmed]
PHST- 2010/06/15 06:00 [medline]
PHST- 2010/03/01 00:00 [pmc-release]
AID - cmr.2009.867 [pii]
AID - 0070007 [pii]
AID - 10.3121/cmr.2009.867 [doi]
PST - ppublish
SO  - Clin Med Res. 2010 Mar;8(1):7-12. doi: 10.3121/cmr.2009.867. Epub 2009 Nov 17.