Conference abstract
Diagnostic value of NT-ProBNP for left ventricular hypertrophy in patients with chronic kidney disease
Pan African Medical Journal - Conference Proceedings. 2023:16(43).15
Mar 2023.
doi: 10.11604/pamj-cp.2023.16.43.1867
Archived on: 15 Mar 2023
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Keywords: Chronic kidney disease, NT-proBNP, left ventricular hypertrophy, diagnosis
Oral presentation
Diagnostic value of NT-ProBNP for left ventricular hypertrophy in patients with chronic kidney disease
Chronic kidney disease, NT-proBNP, left ventricular hypertrophy, diagnosis
1Faculty of Medicine and Pharmaceutical Sciences of the University of Douala, Douala, Cameroon, 2General Hospital of Douala, Douala, Cameroon, 3Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
&Corresponding author
Introduction: left ventricular hypertrophy (LVH) is a prognostic marker for cardiovascular disease in chronic kidney disease (CKD) patients. NT-proBNP is a biomarker released in the setting of LVH hypothesized to increase with declining kidney function. We aimed to assess the diagnostic value of NT-proBNP for LVH in CKD patients.
Methods: we conducted a cross-sectional and analytical study at the Douala General Hospital from January to May 2022. We included stage 1-5 CKD patients without kidney replacement therapy (KRT) nor heart failure matched to patients without CKD nor modifiable cardiovascular risk factors (according to gender, age, and body mass index). In CKD and non-CKD patients, we performed NT-proBNP analysis using enzyme-linked fluorescence assay with Vidas Biomerieux equipment and echocardiography by cardiologists using the VIVID 7 ultrasound system to diagnose LVH. The correlation between left ventricular mass index (LVMI) and NT-ProBNP was assessed and the specificity, sensitivity, and positive and negative predictive values were calculated.
Results: we recruited 109 patients in our study with 57 CKD patients stages 2-5 without KRT matched to 52 healthy controls. The median (IQR) age of CKD patients was 64 (51-70) years. In our study, 41 (72%) of CKD patients were male. Almost half of the patients 25 (43.9%) were in CKD stage 3. In CKD patients, median NT-proBNP of 222 pg/ml (118-737) was higher than in non-CKD patients, 29 pg/ml (19.5-53), p<0.001. Median NT-proBNP increased with CKD stage, p=0.006. LVMI and LVH frequency increased across NT-proBNP quartiles, p=0.015 and p=0.031 respectively. LVMI correlated positively with NT-proBNP (r=0.36, p=0.006) in CKD patients. Area under the survey (AUC) for NT-proBNP was 0.75 (0.59-0.91) 95% CI. An NT-proBNP cut-off at 483.5 pg/ml had a specificity of 83%, sensitivity of 75%, positive predictive value of 63%, and negative predictive value of 90% for LVH.
Conclusion: NT-proBNP is moderately sensitive but highly specific for diagnosing LVH in patients with CKD. These findings may lead to new strategies for cardiovascular risk stratification of patients with CKD using NT-proBNP alone or in combination with already existing tools.
Diagnostic value of NT-ProBNP for left ventricular hypertrophy in patients with chronic kidney disease
Chronic kidney disease, NT-proBNP, left ventricular hypertrophy, diagnosis
1Faculty of Medicine and Pharmaceutical Sciences of the University of Douala, Douala, Cameroon, 2General Hospital of Douala, Douala, Cameroon, 3Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
&Corresponding author
Introduction: left ventricular hypertrophy (LVH) is a prognostic marker for cardiovascular disease in chronic kidney disease (CKD) patients. NT-proBNP is a biomarker released in the setting of LVH hypothesized to increase with declining kidney function. We aimed to assess the diagnostic value of NT-proBNP for LVH in CKD patients.
Methods: we conducted a cross-sectional and analytical study at the Douala General Hospital from January to May 2022. We included stage 1-5 CKD patients without kidney replacement therapy (KRT) nor heart failure matched to patients without CKD nor modifiable cardiovascular risk factors (according to gender, age, and body mass index). In CKD and non-CKD patients, we performed NT-proBNP analysis using enzyme-linked fluorescence assay with Vidas Biomerieux equipment and echocardiography by cardiologists using the VIVID 7 ultrasound system to diagnose LVH. The correlation between left ventricular mass index (LVMI) and NT-ProBNP was assessed and the specificity, sensitivity, and positive and negative predictive values were calculated.
Results: we recruited 109 patients in our study with 57 CKD patients stages 2-5 without KRT matched to 52 healthy controls. The median (IQR) age of CKD patients was 64 (51-70) years. In our study, 41 (72%) of CKD patients were male. Almost half of the patients 25 (43.9%) were in CKD stage 3. In CKD patients, median NT-proBNP of 222 pg/ml (118-737) was higher than in non-CKD patients, 29 pg/ml (19.5-53), p<0.001. Median NT-proBNP increased with CKD stage, p=0.006. LVMI and LVH frequency increased across NT-proBNP quartiles, p=0.015 and p=0.031 respectively. LVMI correlated positively with NT-proBNP (r=0.36, p=0.006) in CKD patients. Area under the survey (AUC) for NT-proBNP was 0.75 (0.59-0.91) 95% CI. An NT-proBNP cut-off at 483.5 pg/ml had a specificity of 83%, sensitivity of 75%, positive predictive value of 63%, and negative predictive value of 90% for LVH.
Conclusion: NT-proBNP is moderately sensitive but highly specific for diagnosing LVH in patients with CKD. These findings may lead to new strategies for cardiovascular risk stratification of patients with CKD using NT-proBNP alone or in combination with already existing tools.
