Brain natriuretic peptide is related to carotid plaques and predicts atherosclerosis in pre-dialysis patients with chronic kidney disease
European Journal of Internal Medicine , 08/17/2012
Zhou W et al. – Similar to findings in the general population, elevated brain natriuretic peptide level is related to atherosclerosis and an increased risk of ischemic cardiovascular events in pre–dialytic chronic kidney disease patients.Methods
- The authors prospectively analyzed 227 pre-dialysis patients with CKD [median estimated glomerular filtration rate (eGFR): 28.82 (11.65–48.20) ml/min/1.73m2].
- At enrollment, BNP concentrations, biochemical and echocardiographic parameters were measured, and carotid artery ultrasound was performed.
- Patients were prospectively followed for a mean 31.8months (range 0.5–57.0months).
- Ischemic CV events and patient outcomes were recorded.
- Median BNP concentration at enrollment was significantly higher in the CKD patients than in a control group [53.9 (16.2–181.0) pg/ml vs. 9.4 (7.0–15.3) pg/ml, P<0.01].
- BNP concentration was positively related with the carotid intima–media thickness of the common carotid artery (CCA-IMT) and left ventricular mass index (LVMI) and was significantly higher in patients with than without carotid plaques (P<0.01).
- Logistic regression analysis confirmed that lgBNP concentration was independently correlated with carotid plaques.
- Thirty-two patients experienced ischemic cardiovascular (ICV) events during follow-up.
- Kaplan–Meier analysis showed that cumulative survival without new ICV events was better in patients with lower than with higher BNP concentrations (P<0.01).
- Cox regression analysis showed that BNP was an independent risk factor for ICV events (HR=3.167, 95%CI=1.398–7.171, P<0.01).