Article Figures & Data
Figures
- Figure 1.
Concentrations of NT-BNP-76 (A) measured at baseline (sample 1) and 5–6 months later (sample 2) increased in patients with CKD and dialysis patients, but not kidney transplant recipients. For BNP-32 (B), no significant change was detected. The median and interquartile ranges are based on natural logarithm–transformed values of B-type natriuretic peptide (BNP) and actual values are given on the y axis. The whiskers represent the data point closest to 1.5 times the interquartile range away from the nearer quartile. BNP-32, 32–amino acid BNP; NT-BNP-76, N-terminal end BNP.
- Figure 2.
Survival was significantly reduced in patients with the greatest tertile of change of NT-BNP-76 for CKD stages 3–4 (A), but not dialysis patients (B).
- Figure 3.
Concentrations of both BNP-32 (A) and NT-BNP-76 (B) were reduced after kidney transplantation. Each line represents an individual patient. Time zero is the date of transplant.
Tables
- Table 1.
Baseline characteristics of the patients who had two measurements of NT-BNP-76 by treatment group
Characteristic CKD 3–4 (n=49) Dialysis (n=102) Transplant (n=71) P Value Age (yr) 67.1±11.2 62.6±14.3 52.8±10.7 <0.001 Men 37 (76) 60 (59) 46 (63) 0.13 Diabetes 21 (43) 20 (20) 8 (11) <0.001 Cardiovascular disease 19 (39) 32 (31) 9 (13) 0.003 Coronary artery disease 15 (31) 24 (24) 4 (6) 0.001 Heart failure 8 (16) 19 (19) 1 (1) 0.002 Cerebrovascular disease 1 (2) 7 (7) 2 (3) 0.29 Peripheral vascular disease 8 (16) 16 (16) 3 (4) 0.05 Smoking 30 (61) 55(54) 36 (51) 0.52 Systolic BP (mmHg) 132±21 145±24 129±14 <0.001 Diastolic BP (mmHg) 76±9 78±13 77±6 0.46 BMI (kg/m2) 27.3 (24.2–31.8) 24.2 (21.8–27.4) 26.5 (23.3–29.8) <0.001 Antiplatelet agent 24 (49) 39 (38) 15 (21) <0.01 RAS blockade 33 (67) 39 (38) 41 (58) 0.001 Statin 26 (53) 46 (45) 44 (62) 0.09 β-Blocker 17 (35) 35 (34) 35 (49) 0.11 eGFR (ml/min per 1.73 m2) 24±11 — 35±16 <0.001 Hemoglobin (g/dl) 12.3±1.6 12.1±1.2 12.9±1.9 0.003 C-reactive protein (mg/L) 3.8 (1.8–7.6) 5.0 (3.0–11.8) 1.6 (0.6–4.6) <0.001 Albumin (g/dl) 4.01±0.39 3.76±0.41 4.12±0.32 <0.001 cTnT-positive (sample 1) 9 (19) 48 (47) 6 (8) <0.001 cTnT-positive (sample 2) 10 (21) 59 (58) 8 (11) <0.001 Results are similar for patients with two measurements of 32–amino acid BNP (data not shown). Values expressed with a plus/minus sign are the mean±SD; all other values are the number (percentage) of patients. NT-BNP-76, N-terminal end B-type natriuretic peptide; BMI, body mass index; RAS, renin-angiotensin system; cTnT-positive, cardiac troponin T≥0.04 ng/ml.
- Table 2.
Median (interquartile range) concentrations of BNP-32 and NT-BNP-76 at baseline (first sample) and 5–6 months later (second sample) and median difference between the two by treatment group
Variable CKD 3–4 Dialysis Transplant BNP-32 (pg/ml) n=48 n=102 n=73 First sample 102 (48–252) 218 (93–445) 66 (41–148) Second sample 103 (34–269) 280 (116–668) 61 (31–161) ΔBNP-32 −9 (−47 to 39) 13 (−66 to 171) −4 (−20 to 19) NT-BNP-76 (pg/ml) n=49 n=102 n=71 First sample 698 (283 to 2,922) 3850 (1776–12,323) 379 (141–875) Second sample 2529 (347–9277)a 18,830 (6114– 61,009)b 347 (144–981) ΔNT-BNP-76 778 (−57 to 7468) 13,772 (2058–41,244) 2 (−74 to 105) - Table 3.
Summary of variables measured at baseline or sample 2 that were associated with change in BNP at the P≤0.05 level
Variable and Predictor Continuous Variables Categorical Variables β-Coefficient (95% CI) P Value Tertile 1, n (%) Tertile 2, n (%) Tertile 3, n (%) P Value NT-BNP-76 CKD 3–4 Male sex 10 (60) 11 (69) 16 (100) 0.02 cTnT-positive (sample 1) 0 2 (13) 7 (44) 0.004 cTnT-positive (sample 2) 0 2 (13) 8 (50) 0.001 Dialysis SBP (mmHg) −0.01 (−0.02 to 0.0) 0.05 cTnT-positive (sample 1) 15 (44) 11 (32) 22 (65) 0.03 cTnT-positive (sample 2) 17 (50) 15 (44) 27 (79) <0.01 KTR cTnT-positive (sample 2) 1 (4) 0 7 (30) 0.002 BNP-32 CKD 3–4 logCRP (mg/L) −0.21 (−0.38 to −0.03) 0.02 Statin use 10 (59) 4 (27) 11 (69) 0.05 cTnT-positive (sample 2) 4 (24) 0 6 (18) 0.04 Dialysis Heart failure 11 (32) 2 (6) 6 (18) 0.02 KTR Hemoglobin (per 10 g/dl) −0.01 (−0.01 to 0.0) 0.02 Albumin (per 1 g/dl) −0.04 (0.07 to 0.0) 0.05 cTnT-positive (sample 1) 1 (4) 0 5 (21) 0.02 cTnT-positive (sample 2) 1 (4) 0 7 (30) 0.002 The β-coefficient is the change in the natural logarithm–transformed ratio of the second to the first BNP sample for each unit change of the variable presented. Categorical variables are presented as the number (percentage) in each progressive tertile of change in BNP. Actual BNP concentrations that define tertiles are available in Supplemental Table 3. SBP, systolic BP; KTR, kidney transplant recipient; CRP, C-reactive protein; 95% CI, 95% confidence interval.
Supplemental Data
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