Anaemia and renal dysfunction are independently associated with BNP and NT-proBNP levels in patients with heart failure

Department of Cardiology, Thoraxcenter, University Medical Centre Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands.
European Journal of Heart Failure (Impact Factor: 6.53). 08/2007; 9(8):787-94. DOI: 10.1016/j.ejheart.2007.04.001
Source: PubMed


Anaemia may affect B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) levels, but this has not been well described in heart failure (HF) patients without the exclusion of patients with renal dysfunction.
To study the influence of both anaemia and renal function on BNP and NT-proBNP levels in a large group of hospitalised HF patients.
We studied 541 patients hospitalised for HF (mean age 71+/-11 years, 62% male, and left ventricular ejection fraction 0.33+/-0.14). Of these patients, 30% (n=159) were anaemic (women: Hb<7.5 mmol/l, men: Hb<8.1 mmol/l). Of the 159 anaemic patients, 73% had renal dysfunction (eGFR<60 ml/min/1.73 m2) and of the non-anaemic patients, 57% had renal dysfunction. BNP and NT-proBNP levels were measured in all patients before discharge. In multivariable analyses both plasma haemoglobin and eGFR were independently related to the levels of BNP and NT-proBNP (standardised beta's of -0.16, -0.14 [BNP] and -0.19, -0.26 [NT-proBNP] respectively, P-values<0.01).
Anaemia and renal dysfunction are related to increased BNP and NT-proBNP levels, independent of the severity of HF. These results indicate that both anaemia and renal dysfunction should be taken into consideration during the interpretation of BNP and NT-proBNP levels in HF patients.

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Available from: Tiny Jaarsma, May 08, 2014
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    • "Hemoglobin levels also can decrease with age. Age and anemia were independently associated with plasma BNP level in our study, as previously reported in a population without AS [11] [27]. "
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    • "As such the use of NTproBNP for assessing CHF, shortness of breath, acute coronary syndrome, and stable chronic coronary heart disease, continues to be valuable for determination of prognosis recognizing that RI and cardiovascular disease may reciprocally influence the production of NT-proBNP until a threshold for worsening RI has been reached. Hogenhuis et al. [40] reported that the NT-proBNP is elevated in patients with renal dysfunction independent of the severity of heart failure. Our data supports this assertion, however, it may be that the rising levels of NT-proBNP in patients with heart failure are masked by very high elevations due to renal failure. "

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