Correlates of N-terminal prohormone brain natriuretic peptides in African Americans with hypertensive chronic kidney disease: The African American study of kidney disease and hypertension

S. Yi, G. Contreras, E. R. Miller, L. J. Appel, B. C. Astor

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Abstract

Background/Aims: The N-amino-terminal fragment of the prohormone B-type natriuretic peptide (NT-proBNP) is a marker of cardiac stress and elevated levels are indicative of heart failure. Few correlates of NT-proBNP levels have been identified in persons with moderate chronic kidney disease (CKD), and data from those without heart failure and from African Americans are especially limited. Methods: The African American Study of Kidney Disease and Hypertension (AASK) enrolled nondiabetic African Americans with hypertensive kidney disease (glomerular filtration rate [GFR] = 20-65 ml/min/1.73 m2) and no evidence of clinical heart failure. NT-proBNP was measured in 982 AASK participants. Results: In unadjusted analyses, GFR (r = -0.39; p < 0.001), hematocrit (r = -0.21; p < 0.001) and body mass index (BMI; r = -0.07; p = 0.04) were inversely correlated, and systolic blood pressure (r = 0.30; p < 0.001) and log UPCR (r = 0.32; p < 0.001) were positively correlated with log NT-proBNP levels. After adjustment for potential confounders, lower GFR and hematocrit and higher systolic blood pressure and protein:creatinine ratio remained significantly associated with higher NT-proBNP. Conclusion: Lower GFR and hematocrit, and higher urinary protein excretion may be associated with volume expansion in CKD. These results suggest that these processes are associated with increased NT-proBNP in CKD and may play a role in the development of heart failure.

Original languageEnglish (US)
Pages (from-to)292-298
Number of pages7
JournalAmerican Journal of Nephrology
Volume29
Issue number4
DOIs
StatePublished - Mar 1 2009

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Keywords

  • Chronic kidney disease
  • Epidemiology
  • Natriuretic peptides

ASJC Scopus subject areas

  • Nephrology

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