Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jan 9;13(2):247.
doi: 10.3390/diagnostics13020247.

Use of Urine N-Terminal Prohormone of Brain-Natriuretic Peptide (NT-proBNP) as a Non-Invasive Indicator for Renal Function Recovery after Surgical Relief of Hydronephrosis

Chia Min Liu  1 , Chan Jung Liu  1   2 , Ze Hong Lu  1 , Ho Shiang Huang  1   2
Affiliations

Use of Urine N-Terminal Prohormone of Brain-Natriuretic Peptide (NT-proBNP) as a Non-Invasive Indicator for Renal Function Recovery after Surgical Relief of Hydronephrosis

Chia Min Liu et al. Diagnostics (Basel). .

Abstract

Cardiorenal syndrome is rarely discussed in patients with obstructive uropathy. On the other hand, there is currently no accurate and convenient clinical biomarker to predict the recovery of renal function after the resolution of ureteral obstruction. The purpose of this study is to explore the association between hydronephrosis and cardiorenal syndrome by measuring the change of the N-terminal prohormone of brain-natriuretic peptide (NT-proBNP), which is a biomarker typically used for cardiac failure, in patients receiving surgery to relieve obstructive uropathy. A total of 212 patients admitted for ureteroscopic (URS) procedures to relieve hydronephrosis were enrolled in this study. The severity of hydronephrosis as well as plasma and urine NT-proBNP levels were obtained before and after surgery. The results showed a significant correlation between urine NT-proBNP levels and renal function recovery following the resolution of hydronephrosis (OR 3.24, 95% CI 1.09−9.70, p = 0.035). Urine NT-proBNP could even predict the recovery of renal function with an area under the ROC = 0.775 (0.65−0.88, p < 0.001). In conclusion, urine NT-proBNP could be a useful early marker of renal function recovery after URS surgery, identifying patients whose renal and heart functions were compromised by the obstruction.

Keywords: NT-proBNP; biomarkers; cardiorenal syndrome; obstructive uropathy; renal function; ureterorenoscopic surgery.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Consort flow diagram.
Figure 2
Figure 2
(a) Plasma NT-proBNP levels were inversely correlated with urine NT-proBNP levels. (b) The change in eGFR is inversely correlated with urine NT-proBNP levels. The lower urine NT-proBNP levels were significantly associated with improved renal function after the surgery.
Figure 3
Figure 3
The comparison of urine NT-proBNP levels between patients with an improved renal function and a deteriorated renal function. * = statistically significant.
Figure 4
Figure 4
A ROC curve for predicting the improvement of renal function after surgery with urine NT-proBNP, AUC = 0.775 (0.65–0.89) and p < 0.001.
See this image and copyright information in PMC

References

    1. Patel K., Batura D. An overview of hydronephrosis in adults. Br. J. Hosp. Med. 2020;81:1–8. doi: 10.12968/hmed.2019.0274. - DOI - PubMed
    1. Rangaswami J., Bhalla V., Blair J.E., Chang T.I., Costa S., Lentine K.L., Lerma E.V., Mezue K., Molitch M., Mullens W. Cardiorenal syndrome: Classification, pathophysiology, diagnosis, and treatment strategies: A scientific statement from the American Heart Association. Circulation. 2019;139:e840–e878. doi: 10.1161/CIR.0000000000000664. - DOI - PubMed
    1. Yeh H.-M., Lin T.-T., Yeh C.-F., Huang H.-S., Chang S.-N., Lin J.-W., Tsai C.-T., Lai L.-P., Huang Y.-Y., Chu C.-L. Biomarkers and echocardiography for evaluating the improvement of the ventricular diastolic function after surgical relief of hydronephrosis. PLoS ONE. 2017;12:e0188597. doi: 10.1371/journal.pone.0188597. - DOI - PMC - PubMed
    1. Weber M., Hamm C. Role of B-type natriuretic peptide (BNP) and NT-proBNP in clinical routine. Heart. 2006;92:843–849. doi: 10.1136/hrt.2005.071233. - DOI - PMC - PubMed
    1. Govoni A.F. Diagnostic Radiology. In: Donald G., Grainger, Allison D., Adam A., Adrian, Dixon D., Livingstone C., editors. A Textbook of Medical Imaging. Volume 1. Imprint of Harcourt Publishers; London, UK: 2001. p. 973. 1145 illustrations.