Correlates of N-terminal prohormone brain natriuretic peptides in African Americans with hypertensive chronic kidney disease: The African American study of kidney disease and hypertension

S. Yi, G. Contreras, Edgar R Miller, Lawrence Appel, B. C. Astor

Research output: Contribution to journalArticle

Abstract

Background/Aims: The N-amino-terminal fragment of the prohormone B-type natriuretic peptide (NT-proBNP) is a marker of cardiac stress and elevated levels are indicative of heart failure. Few correlates of NT-proBNP levels have been identified in persons with moderate chronic kidney disease (CKD), and data from those without heart failure and from African Americans are especially limited. Methods: The African American Study of Kidney Disease and Hypertension (AASK) enrolled nondiabetic African Americans with hypertensive kidney disease (glomerular filtration rate [GFR] = 20-65 ml/min/1.73 m2) and no evidence of clinical heart failure. NT-proBNP was measured in 982 AASK participants. Results: In unadjusted analyses, GFR (r = -0.39; p <0.001), hematocrit (r = -0.21; p <0.001) and body mass index (BMI; r = -0.07; p = 0.04) were inversely correlated, and systolic blood pressure (r = 0.30; p <0.001) and log UPCR (r = 0.32; p <0.001) were positively correlated with log NT-proBNP levels. After adjustment for potential confounders, lower GFR and hematocrit and higher systolic blood pressure and protein:creatinine ratio remained significantly associated with higher NT-proBNP. Conclusion: Lower GFR and hematocrit, and higher urinary protein excretion may be associated with volume expansion in CKD. These results suggest that these processes are associated with increased NT-proBNP in CKD and may play a role in the development of heart failure.

Original languageEnglish (US)
Pages (from-to)292-298
Number of pages7
JournalAmerican Journal of Nephrology
Volume29
Issue number4
DOIs
StatePublished - Mar 2009

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Brain Natriuretic Peptide
Kidney Diseases
Chronic Renal Insufficiency
African Americans
Hypertension
Glomerular Filtration Rate
Heart Failure
Hematocrit
Blood Pressure
pro-brain natriuretic peptide (1-76)
Blood Proteins
Creatinine
Body Mass Index
Proteins

Keywords

  • Chronic kidney disease
  • Epidemiology
  • Natriuretic peptides

ASJC Scopus subject areas

  • Nephrology

Cite this

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title = "Correlates of N-terminal prohormone brain natriuretic peptides in African Americans with hypertensive chronic kidney disease: The African American study of kidney disease and hypertension",
abstract = "Background/Aims: The N-amino-terminal fragment of the prohormone B-type natriuretic peptide (NT-proBNP) is a marker of cardiac stress and elevated levels are indicative of heart failure. Few correlates of NT-proBNP levels have been identified in persons with moderate chronic kidney disease (CKD), and data from those without heart failure and from African Americans are especially limited. Methods: The African American Study of Kidney Disease and Hypertension (AASK) enrolled nondiabetic African Americans with hypertensive kidney disease (glomerular filtration rate [GFR] = 20-65 ml/min/1.73 m2) and no evidence of clinical heart failure. NT-proBNP was measured in 982 AASK participants. Results: In unadjusted analyses, GFR (r = -0.39; p <0.001), hematocrit (r = -0.21; p <0.001) and body mass index (BMI; r = -0.07; p = 0.04) were inversely correlated, and systolic blood pressure (r = 0.30; p <0.001) and log UPCR (r = 0.32; p <0.001) were positively correlated with log NT-proBNP levels. After adjustment for potential confounders, lower GFR and hematocrit and higher systolic blood pressure and protein:creatinine ratio remained significantly associated with higher NT-proBNP. Conclusion: Lower GFR and hematocrit, and higher urinary protein excretion may be associated with volume expansion in CKD. These results suggest that these processes are associated with increased NT-proBNP in CKD and may play a role in the development of heart failure.",
keywords = "Chronic kidney disease, Epidemiology, Natriuretic peptides",
author = "S. Yi and G. Contreras and Miller, {Edgar R} and Lawrence Appel and Astor, {B. C.}",
year = "2009",
month = "3",
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pages = "292--298",
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T1 - Correlates of N-terminal prohormone brain natriuretic peptides in African Americans with hypertensive chronic kidney disease

T2 - The African American study of kidney disease and hypertension

AU - Yi, S.

AU - Contreras, G.

AU - Miller, Edgar R

AU - Appel, Lawrence

AU - Astor, B. C.

PY - 2009/3

Y1 - 2009/3

N2 - Background/Aims: The N-amino-terminal fragment of the prohormone B-type natriuretic peptide (NT-proBNP) is a marker of cardiac stress and elevated levels are indicative of heart failure. Few correlates of NT-proBNP levels have been identified in persons with moderate chronic kidney disease (CKD), and data from those without heart failure and from African Americans are especially limited. Methods: The African American Study of Kidney Disease and Hypertension (AASK) enrolled nondiabetic African Americans with hypertensive kidney disease (glomerular filtration rate [GFR] = 20-65 ml/min/1.73 m2) and no evidence of clinical heart failure. NT-proBNP was measured in 982 AASK participants. Results: In unadjusted analyses, GFR (r = -0.39; p <0.001), hematocrit (r = -0.21; p <0.001) and body mass index (BMI; r = -0.07; p = 0.04) were inversely correlated, and systolic blood pressure (r = 0.30; p <0.001) and log UPCR (r = 0.32; p <0.001) were positively correlated with log NT-proBNP levels. After adjustment for potential confounders, lower GFR and hematocrit and higher systolic blood pressure and protein:creatinine ratio remained significantly associated with higher NT-proBNP. Conclusion: Lower GFR and hematocrit, and higher urinary protein excretion may be associated with volume expansion in CKD. These results suggest that these processes are associated with increased NT-proBNP in CKD and may play a role in the development of heart failure.

AB - Background/Aims: The N-amino-terminal fragment of the prohormone B-type natriuretic peptide (NT-proBNP) is a marker of cardiac stress and elevated levels are indicative of heart failure. Few correlates of NT-proBNP levels have been identified in persons with moderate chronic kidney disease (CKD), and data from those without heart failure and from African Americans are especially limited. Methods: The African American Study of Kidney Disease and Hypertension (AASK) enrolled nondiabetic African Americans with hypertensive kidney disease (glomerular filtration rate [GFR] = 20-65 ml/min/1.73 m2) and no evidence of clinical heart failure. NT-proBNP was measured in 982 AASK participants. Results: In unadjusted analyses, GFR (r = -0.39; p <0.001), hematocrit (r = -0.21; p <0.001) and body mass index (BMI; r = -0.07; p = 0.04) were inversely correlated, and systolic blood pressure (r = 0.30; p <0.001) and log UPCR (r = 0.32; p <0.001) were positively correlated with log NT-proBNP levels. After adjustment for potential confounders, lower GFR and hematocrit and higher systolic blood pressure and protein:creatinine ratio remained significantly associated with higher NT-proBNP. Conclusion: Lower GFR and hematocrit, and higher urinary protein excretion may be associated with volume expansion in CKD. These results suggest that these processes are associated with increased NT-proBNP in CKD and may play a role in the development of heart failure.

KW - Chronic kidney disease

KW - Epidemiology

KW - Natriuretic peptides

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