N-Terminal Pro-B-Type Natriuretic Peptide and Incident CKD

Takaya Sasaki; Emi Oishi; Takuya Nagata; Satoko Sakata; Sanmei Chen; Yoshihiko Furuta; Takanori Honda; Daigo Yoshida; Jun Hata; Nobuo Tsuboi; Takanari Kitazono; Takashi Yokoo; Toshiharu Ninomiya

doi:10.1016/j.ekir.2021.01.006

N-Terminal Pro-B-Type Natriuretic Peptide and Incident CKD

Kidney Int Rep. 2021 Jan 16;6(4):976-985. doi: 10.1016/j.ekir.2021.01.006. eCollection 2021 Apr.

Authors

Takaya Sasaki^{1

2}, Emi Oishi^{1

3}, Takuya Nagata^{1

4}, Satoko Sakata^{1

3

5}, Sanmei Chen¹, Yoshihiko Furuta^{1

3}, Takanori Honda¹, Daigo Yoshida¹, Jun Hata^{1

3

5}, Nobuo Tsuboi², Takanari Kitazono^{3

5}, Takashi Yokoo², Toshiharu Ninomiya^{1

5}

Affiliations

¹ Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
² Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.
³ Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
⁴ Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
⁵ Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Abstract

Introduction: Serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels have been associated with the progression of kidney impairment among patients with chronic kidney disease (CKD), but only a few studies have investigated the association between serum NT-proBNP levels and incident CKD in general populations.

Methods: A total of 2486 Japanese community-dwelling residents ≥40 years of age without CKD at baseline were followed up by repeated annual health examinations for 10 years. Participants were divided into 4 groups according to serum NT-proBNP levels. CKD was defined as an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73m² or the presence of proteinuria. Cox proportional hazards models were used to estimate hazard ratios (HRs) for risk of CKD. Linear mixed models were used to compare changes in eGFR.

Results: During the follow-up period, 800 participants developed CKD. The multivariable-adjusted HRs (95% confidence intervals [CIs]) for developing CKD were 1.00 (reference), 1.32 (1.11-1.57), 1.40 (1.10-1.78), and 1.94 (1.38-2.73) for serum NT-proBNP levels of <55, 55-124, 125-299, and ≥300 pg/ml, respectively (P for trend <0.001). The decline of eGFR during the follow-up was significantly more rapid among participants with higher serum NT-proBNP levels (P for trend <0.001). Adding serum NT-proBNP to the model composed of known risk factors for CKD improved the predictive ability for developing CKD.

Conclusions: Higher serum NT-proBNP levels were associated with greater risks of developing CKD and greater decline in eGFR. Serum NT-proBNP could be a useful biomarker for assessing the future risk of CKD in a general Japanese population.

Keywords: chronic kidney disease; community-based cohort study; kidney dysfunction; natriuretic peptide; proteinuria; renal impairment.