1. Effect of renal failure on N-terminal Pro-Brain natriuretic peptide in patients admitted to emergency department with acute dyspnea
- Author
-
Ayfer Colak, Oner Ozdogan, Serap Çuhadar, Yalcin Golcuk, Isil Coker, and Burcu Golcuk
- Subjects
Male ,medicine.medical_specialty ,medicine.drug_class ,Population ,Renal function ,Patient Admission ,Predictive Value of Tests ,Internal medicine ,Natriuretic Peptide, Brain ,medicine ,Natriuretic peptide ,Humans ,Renal Insufficiency ,cardiovascular diseases ,education ,Heart Failure ,education.field_of_study ,Ejection fraction ,business.industry ,Emergency department ,medicine.disease ,Peptide Fragments ,Cross-Sectional Studies ,Dyspnea ,ROC Curve ,Echocardiography ,Concomitant ,Heart failure ,Predictive value of tests ,Cardiology ,Female ,Emergency Service, Hospital ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers ,hormones, hormone substitutes, and hormone antagonists - Abstract
OBJECTIVE Preexisting renal failure diminishes the excretion of N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP), therefore limits the diagnostic value of this peptide for concomitant heart failure. The aim of this study was to evaluate the association between NT-proBNP and the stages of renal dysfunction in a typical population attended to emergency department with acute dyspnea. METHODS In this cross-sectional study, all consecutive patients with acute dyspnea underwent clinical evaluation, laboratory assessment of NT-proBNP, and echocardiographic examinations. Among subjects, 54.5% were diagnosed as heart failure. Grouping variables according to renal function capacity and ejection fraction, independent variables were compared with Kruskal-Wallis or ANOVA with posthoc tests. Correlation and linear regression analysis were done to analyze the variables associated with NT-proBNP. The diagnostic performance of NT-proBNP was evaluated by receiver-operating characteristic (ROC) curve. RESULTS Serum median NT-proBNP level in patients with severe renal impairment was significantly higher than moderate and mildly decreased renal functions (p=0.001). In patients with moderate and severe left ventricular failure, NT-proBNP was significantly higher compared with normal subjects (LVEF>50%) (p=0.040, and 0.017, respectively). Renal dysfunction was associated in 56% of patients with heart failure. The area under the ROC curve of NT-proBNP for identifying left ventricular failure in patients with renal failure (eGFR
- Published
- 2014
- Full Text
- View/download PDF