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. 2021 Jan 16;6(4):976-985.
doi: 10.1016/j.ekir.2021.01.006. eCollection 2021 Apr.

N-Terminal Pro-B-Type Natriuretic Peptide and Incident CKD

Takaya Sasaki  1   2 , Emi Oishi  1   3 , Takuya Nagata  1   4 , Satoko Sakata  1   3   5 , Sanmei Chen  1 , Yoshihiko Furuta  1   3 , Takanori Honda  1 , Daigo Yoshida  1 , Jun Hata  1   3   5 , Nobuo Tsuboi  2 , Takanari Kitazono  3   5 , Takashi Yokoo  2 , Toshiharu Ninomiya  1   5
Affiliations

N-Terminal Pro-B-Type Natriuretic Peptide and Incident CKD

Takaya Sasaki et al. Kidney Int Rep. .

Abstract

Introduction: Serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels have been associated with the progression of kidney impairment among patients with chronic kidney disease (CKD), but only a few studies have investigated the association between serum NT-proBNP levels and incident CKD in general populations.

Methods: A total of 2486 Japanese community-dwelling residents ≥40 years of age without CKD at baseline were followed up by repeated annual health examinations for 10 years. Participants were divided into 4 groups according to serum NT-proBNP levels. CKD was defined as an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73m2 or the presence of proteinuria. Cox proportional hazards models were used to estimate hazard ratios (HRs) for risk of CKD. Linear mixed models were used to compare changes in eGFR.

Results: During the follow-up period, 800 participants developed CKD. The multivariable-adjusted HRs (95% confidence intervals [CIs]) for developing CKD were 1.00 (reference), 1.32 (1.11-1.57), 1.40 (1.10-1.78), and 1.94 (1.38-2.73) for serum NT-proBNP levels of <55, 55-124, 125-299, and ≥300 pg/ml, respectively (P for trend <0.001). The decline of eGFR during the follow-up was significantly more rapid among participants with higher serum NT-proBNP levels (P for trend <0.001). Adding serum NT-proBNP to the model composed of known risk factors for CKD improved the predictive ability for developing CKD.

Conclusions: Higher serum NT-proBNP levels were associated with greater risks of developing CKD and greater decline in eGFR. Serum NT-proBNP could be a useful biomarker for assessing the future risk of CKD in a general Japanese population.

Keywords: chronic kidney disease; community-based cohort study; kidney dysfunction; natriuretic peptide; proteinuria; renal impairment.

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Figures

None
Graphical abstract
Figure 1
Figure 1
The annual change rates in the estimated glomerular filtration (eGFR) according to the serum N-terminal pro–B-type natriuretic peptide (NT-proBNP) levels. The annual change rates of eGFR were adjusted for age, sex, systolic blood pressure, use of antihypertensive medication, diabetes mellitus, serum total cholesterol, serum high-density lipoprotein cholesterol, serum triglycerides, use of lipid-modifying medication, body mass index, serum uric acid, estimated glomerular filtration rate at baseline, current smoking, current drinking, regular exercise, and serum high-sensitivity C-reactive protein. Boxes indicate the point estimates and bars indicate the 95% confidence intervals of the annual change rates of eGFR. ∗P < 0.001 vs. serum NT-proBNP levels of <55 pg/ml.
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