Blood concentrations of B-type natriuretic peptide and N-terminal prohormone B-type natriuretic peptide as markers of left ventricle diastolic function in patients with chronic renal failure

Milica Petrović; Aleksandra Grdinić; Dubravko Bokonjić; Violeta Rabrenović; Svetlana Antić; Brankica Terzić; Dušica Stamenković; Zoran Stajić; Dejan Petrović; Ljiljana Ignjatović; Janko Pejović; Dragan Jovanović

doi:10.2298/VSP151019079P

Milica Petrović Military Medical Academy, Clinic of Nephrology, Belgrade, Serbia.
Aleksandra Grdinić Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia; Military Medical Academy, Clinic of Cardiology, Belgrade, Serbia.
Dubravko Bokonjić Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia; Military Medical Academy, National Poisoning Control Centre, Belgrade, Serbia.
Violeta Rabrenović Military Medical Academy, Clinic of Nephrology, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia.
Svetlana Antić Military Medical Academy, Clinic of Nephrology, Belgrade, Serbia.
Brankica Terzić Military Medical Academy, Clinic of Nephrology, Belgrade, Serbia.
Dušica Stamenković Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia; Military Medical Academy, Clinic of Anesthesiology and Intensive Therapy, Belgrade, Serbia.
Zoran Stajić Institute for Health Protection of the Ministry of Interior, Department of Internal Medicine, Belgrade, Serbia.
Dejan Petrović University Clinical Center, Clinic of Urology and Nephrology, Kragujevac, Serbia.
Ljiljana Ignjatović Military Medical Academy, Clinic of Nephrology, Belgrade, Serbia.
Janko Pejović Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia; Institute of Medical Biochemistry, Belgrade, Serbia.
Dragan Jovanović Military Medical Academy, Clinic of Nephrology, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia.

DOI: https://doi.org/10.2298/VSP151019079P

Keywords: kidney failure, chronic, glomerular filtration rate, ventricular function, left, natriuretic peptides, biological markers, sensitivity and specificity,

Abstract

Background/Aim. Patients with chronic renal failure (CRF) have increased cardiovascular morbidity and mortality. It is unknown which biomarkers best describe the degree of diastolic dysfunction in patients with CRF. The aim of this study was to determine the correlation between B-type natriuretic peptide (BNP), N-terminal prohormone brain natriuretic peptide (NTproBNP) and left ventricular diastolic dysfunction (DD-LV) with the degree of CRF. Methods. The study included 100 adult patients with CRF without major cardiac and cerebral incidents who did not start actively treating CRF. According to the degree of CRF, the patients were divided into two groups: G1 (moderate degree), glomerular filtration rate (GFR) ≥ 30 mL/min/1.73 m², and G2 (more severe degree), GFR < 30 mL/min/1.73 m². Blood concentrations of BNP and NTproBNP were measured and Doppler echocardiographic measurement performed to estimate diastolic dysfunction (DD-LV). According to the degree of DD-LV, all the patients were divided into two groups: DD-LV1 (mild diastolic dysfunction) and DD-LV2 (severe diastolic dysfunction). According to the degree of CRF and DD-LV, the patients were divided into four groups: I (G1, DD-LV1), II (G1, DD-LV2), III (G2, DD-LV1) and IV (G2, DD-LV2). Results. There was a highly significant statistical correlation between BNP and NTproBNP with GFR (p < 0.001), and DD-LV with BNP (p < 0.023) and NTproBNP (p = 0.035). In patients with DD-LV2, a statistically significantly higher BNP concentrations were registered in patients with G2 (p < 0.001). Unlike BNP in the patients with diastolic dysfunction DD-LV1 and those with diastolic dysfunction DD-LV2, significantly higher concentrations of NTproBNP were registered in the patients with G2 (DD- LV1: p = 0.006; DD-LV2: p < 0.001). Conclusion. Biomarkers BNP and NTproBNP are not the best predictors in the assessment of diastolic dysfunction because they are correlated with the degree of renal insufficiency.

Author Biographies

Milica Petrović, Military Medical Academy, Clinic of Nephrology, Belgrade, Serbia.

Clinic of Nephrology

Aleksandra Grdinić, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia; Military Medical Academy, Clinic of Cardiology, Belgrade, Serbia.

Clinic of Cardiology

Dubravko Bokonjić, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia; Military Medical Academy, National Poisoning Control Centre, Belgrade, Serbia.

Centre for Control of Poisoning

Violeta Rabrenović, Military Medical Academy, Clinic of Nephrology, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia.

Clinic of Nephrology

Svetlana Antić, Military Medical Academy, Clinic of Nephrology, Belgrade, Serbia.

Clinic of Nephrology

Brankica Terzić, Military Medical Academy, Clinic of Nephrology, Belgrade, Serbia.

Clinic of Nephrology

Dušica Stamenković, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia; Military Medical Academy, Clinic of Anesthesiology and Intensive Therapy, Belgrade, Serbia.

Clinic of Anesthesiology and Intensive Therapy

Zoran Stajić, Institute for Health Protection of the Ministry of Interior, Department of Internal Medicine, Belgrade, Serbia.

Department of Internal Medicine

Dejan Petrović, University Clinical Center, Clinic of Urology and Nephrology, Kragujevac, Serbia.

Clinic of Urology and Nephrology

Ljiljana Ignjatović, Military Medical Academy, Clinic of Nephrology, Belgrade, Serbia.

Clinic of Nephrology

Janko Pejović, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia; Institute of Medical Biochemistry, Belgrade, Serbia.

Institute of Medical Biochemistry

Dragan Jovanović, Military Medical Academy, Clinic of Nephrology, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia.

Clinic of Nephrology

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