Plasma NT-pro BNP Concentrations in Patients with Hypertensive Chronic Kidney Disease

Background and Aims: Plasma N-amino terminal fragment of the prohormone B-type natriuretic peptide(NT-proBNP) is produced and released from cardiac ventricles; it is elevated in patient with heart failure,hypertension and chronic kidney disease (CKD). This study aims to examine the plasma levels of NTproBNPand their relationship in hypertensive patients with or without CKD.

Methods: Our study population consisted of 129 patients with hypertensive CKD (stage 1-4) (Group 1)and 41 controls with hypertensive normal kidney function (Groups 2). Patients with CKD were divided intotwo groups. Group 1A (n=89) with diabetes mellitus, Group 1B (n=40) without diabetes mellitus. Serumcreatinine, NT-proBNP concentrations and proteinuria were analyzed and glomerular filtration rate, bloodpressure, weight, height were measured.

Results: The patients with hypertensive CKD were older compared to the controls (p=0.047), BMI was notstatistically significant (p>0.05). NT-pro BNP concentrations were significantly elevated in the group 1, compared to the group 2 (p=0.007). Notably, there was no significant difference between Group 1A and Group 1B (p>0.05). NT-proBNP concentrations correlated positively with longer diabetes duration (r=0.34, p=0.001),proteinuria (r=0.30, P=0.001) and negatively with BMI (r=-0.20, p=0.02) and GFR (r=-0.29, p=0.001).

Conclusions: In patients with hypertensive CKD, levels of NT-proBNP concentrations are increased. There was no significant difference between diabetic and non diabetic patients with CKD. Because of the relationship between proteinuria and Pro-BNP, increased plasma NT-proBNP concentrations may be a risk factor for the progression of renal disease. The relationship between elevated NT-proBNP and proteinuria should be further investigated.