The comparative diagnostic efficacy of BNP & NT-proBNP in Chronic kidney disease patients with complications

Abstract

Objective: To study the differences between the B-type Natriuretic Peptide (BNP) and the N-terminal pro-B-type Natriuretic Peptide (NT-proBNP) values in CKD patients due to diabetes and hypertension and without CKD. Another objective was to to observe what correlation the variables of age showed with the parameters of BNP, NT-proBNP values, and with Glomerular Filtration Rate (GFR).

Methods: A case-control study was performed for six months between January to June 2024. In total 254 individuals took part in the study, with ages between 30-75 years, of which 85 were healthy controls and 169 CKD cases. CKD patients were recruited from the Department of Nephrology Jinnah Postgraduate Medical Centre (JPMC), Karachi. Diagnosis was made on the basis of raised serum urea, creatinine levels, and electrolyte imbalance. The following were excluded from participation: individuals with coronary artery disease, pregnancy, more than twice-weekly dialysis, or on steroid therapy. CKD cases were also staged according to National Kidney Foundation GFR guidelines.

Results: Among the <50-year-old participants, BNP was abnormal in 92.7% of patients (p = 0.001), while NT-proBNP was abnormal in 38.5% (p = 0.01). When BNP and NT-proBNP were compared between the same individuals, BNP detected more abnormal cases, with a statistically significant difference (p = 0.01), indicating its better diagnostic yield in this group.

Conclusion: BNP was identified as a more authentic marker than NT-proBNP in order to detect cardiovascular stress in CKD patients. Its close correlation with increasing age and decreasing GFR highlights its prognostic significance and potential role in routine cardiovascular risk assessment in CKD populations.

Keywords: B-type Natriuretic Peptide; Cardiovascular Risk; Chronic Kidney Disease; Glomerular Filtration Rate; N-terminal pro-B-type Natriuretic Peptide.