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Association of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and acute kidney disease in patients undergoing coronary angiography: a cohort study

  • Nephrology - Original Paper
  • Published:
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Abstract

Background

Acute kidney disease (AKD) following coronary angiography (CAG) indicates a higher risk of chronic kidney disease and follow-up cardiovascular comorbidities. However, the predictive risk factor of AKD is not clear. We sought to verify whether preoperative N-terminal pro-B-type natriuretic peptide (NT-proBNP) level was associated with AKD in patients undergoing CAG.

Method

We analyzed 7602 patients underwent CAG in this multi-center registry cohort study. Cardiorenal ImprovemeNt II (CIN-II) in five Chinese tertiary hospitals from 2007 to 2020. The primary outcome was AKD, defined as a ≥ 50% increase of serum creatinine within 7–90 days. Multivariable logistic regressions were used to assess the association between NT-proBNP and AKD.

Result

1009 patients (13.27%) eventually developed AKD, who were more likely to be female, older, and with comorbidities of chronic heart failure and anemia. After adjusting to the potential confounders, the NT-proBNP level remained an independent predictor of AKD (lnNT-proBNP OR: 1.20, 95% CI 1.13–1.28, p < 0.005). Restricted cubic spline analysis demonstrated a linear relationship between elevated NT-proBNP and AKD (p for trend < 0.001). In the subgroup analysis, elevated NT-proBNP level in patients with percutaneous coronary intervention (p for interaction < 0.001) or without previous congestive heart failure (p for interaction = 0.0346) has a more significant value of AKD prediction.

Conclusion

Pre-operative NT-proBNP level was independently associated with the risk of AKD in patients following CAG. Perioperative strategies are warranted to prevent AKD in patients with elevated NT-proBNP levels.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. McCullough PA, Choi JP, Feghali GA, Schussler JM, Stoler RM, Vallabahn RC, Mehta A (2016) Contrast-induced acute kidney injury. J Am Coll Cardiol 68(13):1465–1473

    Article  PubMed  Google Scholar 

  2. Chawla LS, Bellomo R, Bihorac A, Goldstein SL, Siew ED, Bagshaw SM, Bittleman D, Cruz D, Endre Z, Fitzgerald RL et al (2017) Acute kidney disease and renal recovery: consensus report of the acute disease quality initiative (ADQI) 16 workgroup. Nat Rev Nephrol 13(4):241–257

    Article  PubMed  Google Scholar 

  3. Xiao YQ, Cheng W, Wu X, Yan P, Feng LX, Zhang NY, Li XW, Duan XJ, Wang HS, Peng JC et al (2020) Novel risk models to predict acute kidney disease and its outcomes in a Chinese hospitalized population with acute kidney injury. Sci Rep 10(1):15636

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. James MT, Levey AS, Tonelli M, Tan Z, Barry R, Pannu N, Ravani P, Klarenbach SW, Manns BJ, Hemmelgarn BR (2019) Incidence and prognosis of acute kidney diseases and disorders using an integrated approach to laboratory measurements in a universal health care system. JAMA Netw Open 2(4):e191795

    Article  PubMed  PubMed Central  Google Scholar 

  5. Nagata K, Horino T, Hatakeyama Y, Matsumoto T, Terada Y, Okuhara Y (2021) Effects of transient acute kidney injury, persistent acute kidney injury and acute kidney disease on the long-term renal prognosis after an initial acute kidney injury event. Nephrology (Carlton) 26(4):312–318

    Article  CAS  PubMed  Google Scholar 

  6. Peerapornratana S, Priyanka P, Wang S, Smith A, Singbartl K, Palevsky PM, Chawla LS, Yealy DM, Angus DC, Kellum JA (2020) Sepsis-associated acute kidney disease. Kidney Int Rep 5(6):839–850

    Article  PubMed  PubMed Central  Google Scholar 

  7. Ostermann M, Bellomo R, Burdmann EA, Doi K, Endre ZH, Goldstein SL, Kane-Gill SL, Liu KD, Prowle JR, Shaw AD et al (2020) Controversies in acute kidney injury: conclusions from a Kidney Disease: improving Global Outcomes (KDIGO) Conference. Kidney Int 98(2):294–309

    Article  PubMed  PubMed Central  Google Scholar 

  8. Kimmel LA, Wilson S, Janardan JD, Liew SM, Walker RG (2014) Incidence of acute kidney injury following total joint arthroplasty: a retrospective review by RIFLE criteria. Clin Kidney J 7(6):546–551

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Hassan BK, Sahlström A, Dessau RB (2015) Risk factors for renal dysfunction after total hip joint replacement; a retrospective cohort study. J Orthop Surg Res 10:158

    Article  PubMed  PubMed Central  Google Scholar 

  10. Praga M, Sevillano A, Auñón P, González E (2015) Changes in the aetiology, clinical presentation and management of acute interstitial nephritis, an increasingly common cause of acute kidney injury. Nephrol Dial Transplant Off Publ Eur Dial Transpl Assoc Eur Renal Assoc 30(9):1472–1479

    CAS  Google Scholar 

  11. Naruse H, Ishii J, Takahashi H, Kitagawa F, Nishimura H, Kawai H, Muramatsu T, Harada M, Yamada A, Motoyama S et al (2018) Predicting acute kidney injury using urinary liver-type fatty-acid binding protein and serum N-terminal pro-B-type natriuretic peptide levels in patients treated at medical cardiac intensive care units. Crit Care (Lond Engl) 22(1):197

    Article  Google Scholar 

  12. Haines R, Crichton S, Wilson J, Treacher D, Ostermann M (2017) Cardiac biomarkers are associated with maximum stage of acute kidney injury in critically ill patients: a prospective analysis. Crit Care (Lond Engl) 21(1):88

    Article  Google Scholar 

  13. Fujii T, Uchino S, Takinami M, Bellomo R (2014) Subacute kidney injury in hospitalized patients. Clin J Am Soc Nephrol CJASN 9(3):457–461

    Article  PubMed  Google Scholar 

  14. Matsuura R, Iwagami M, Moriya H, Ohtake T, Hamasaki Y, Nangaku M, Doi K, Kobayashi S, Noiri E (2020) The clinical course of acute kidney disease after cardiac surgery: a retrospective observational study. Sci Rep 10(1):6490

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Wolsk E, Claggett B, Pfeffer MA, Diaz R, Dickstein K, Gerstein HC, Lawson FC, Lewis EF, Maggioni AP, McMurray JJV et al (2017) Role of B-type natriuretic peptide and N-terminal prohormone BNP as predictors of cardiovascular morbidity and mortality in patients with a recent coronary event and type 2 diabetes mellitus. J Am Heart Assoc. https://doi.org/10.1161/JAHA.116.004743

    Article  PubMed  PubMed Central  Google Scholar 

  16. Santaguida PL, Don-Wauchope AC, Oremus M, McKelvie R, Ali U, Hill SA, Balion C, Booth RA, Brown JA, Bustamam A et al (2014) BNP and NT-proBNP as prognostic markers in persons with acute decompensated heart failure: a systematic review. Heart Fail Rev 19(4):453–470

    Article  CAS  PubMed  Google Scholar 

  17. Oremus M, Don-Wauchope A, McKelvie R, Santaguida PL, Hill S, Balion C, Booth R, Brown JA, Ali U, Bustamam A et al (2014) BNP and NT-proBNP as prognostic markers in persons with chronic stable heart failure. Heart Fail Rev 19(4):471–505

    Article  CAS  PubMed  Google Scholar 

  18. Hall C (2004) Essential biochemistry and physiology of (NT-pro)BNP. Eur J Heart Fail 6(3):257–260

    Article  CAS  PubMed  Google Scholar 

  19. Cao Z, Jia Y, Zhu B (2019) BNP and NT-proBNP as diagnostic biomarkers for cardiac dysfunction in both clinical and forensic medicine. Int J Mol Sci 20(8):1820

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Silver MA, Maisel A, Yancy CW, McCullough PA, Burnett JC Jr, Francis GS, Mehra MR, Fonarow G, Gibler WB et al (2004) BNP Consensus Panel 2004: a clinical approach for the diagnostic, prognostic, screening, treatment monitoring, and therapeutic roles of natriuretic peptides in cardiovascular diseases. Congest Heart Fail (Greenwich, Conn) 10(5 Suppl 3):1–30

    CAS  Google Scholar 

  21. Moltrasio M, Cabiati A, Milazzo V, Rubino M, De Metrio M, Discacciati A, Rumi P, Marana I, Marenzi G (2014) B-type natriuretic peptide and risk of acute kidney injury in patients hospitalized with acute coronary syndromes*. Crit Care Med 42(3):619–624

    Article  CAS  PubMed  Google Scholar 

  22. Goussot S, Mousson C, Guenancia C, Stamboul K, Brunel P, Brunet D, Touzery C, Cottin Y, Zeller M (2015) N-terminal fragment of pro B-type natriuretic peptide as a marker of contrast-induced nephropathy after primary percutaneous coronary intervention for ST-segment elevation myocardial infarction. Am J Cardiol 116(6):865–871

    Article  CAS  PubMed  Google Scholar 

  23. Liu YH, Jiang L, Chen JY, Tan N, Liu Y, He PC (2016) Does N-terminal pro-brain natriuretic peptide add prognostic value to the Mehran risk score for contrast-induced nephropathy and long-term outcomes after primary percutaneous coronary intervention? Int Urol Nephrol 48(10):1675–1682

    Article  CAS  PubMed  Google Scholar 

  24. Welsh P, Woodward M, Hillis GS, Li Q, Marre M, Williams B, Poulter N, Ryan L, Harrap S, Patel A et al (2014) Do cardiac biomarkers NT-proBNP and hsTnT predict microvascular events in patients with type 2 diabetes? Results from the ADVANCE trial. Diabetes Care 37(8):2202–2210

    Article  CAS  PubMed  Google Scholar 

  25. Bidadkosh A, Lambooy SPH, Heerspink HJ, Pena MJ, Henning RH, Buikema H, Deelman LE (2017) Predictive properties of biomarkers GDF-15, NTproBNP, and hs-TnT for morbidity and mortality in patients with type 2 diabetes with nephropathy. Diabetes Care 40(6):784–792

    Article  CAS  PubMed  Google Scholar 

  26. Ronco C, Bellasi A, Di Lullo L (2018) Cardiorenal syndrome: an overview. Adv Chronic Kidney Dis 25(5):382–390

    Article  PubMed  Google Scholar 

  27. Kofman N, Margolis G, Gal-Oz A, Letourneau-Shesaf S, Keren G, Rozenbaum Z, Shacham Y (2019) Long-term renal outcomes and mortality following renal injury among myocardial infarction patients treated by primary percutaneous intervention. Coron Artery Dis 30(2):87–92

    Article  PubMed  Google Scholar 

  28. Chalikias G, Drosos I, Tziakas DN (2016) Contrast-induced acute kidney injury: an update. Cardiovasc Drugs Ther 30(2):215–228

    Article  CAS  PubMed  Google Scholar 

  29. Hur M, Koo CH, Lee HC, Park SK, Kim M, Kim WH, Kim JT, Bahk JH (2017) Preoperative aspirin use and acute kidney injury after cardiac surgery: a propensity-score matched observational study. PLoS One 12(5):e0177201

    Article  PubMed  PubMed Central  Google Scholar 

  30. Su X, Xie X, Liu L, Lv J, Song F, Perkovic V, Zhang H (2017) Comparative effectiveness of 12 treatment strategies for preventing contrast-induced acute kidney injury: a systematic review and Bayesian network meta-analysis. Am J Kidney Dis 69(1):69–77

    Article  CAS  PubMed  Google Scholar 

  31. Pattharanitima P, Tasanarong A (2014) Pharmacological strategies to prevent contrast-induced acute kidney injury. Biomed Res Int 2014:236930

    Article  PubMed  PubMed Central  Google Scholar 

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Funding

This work was supported by grants from Beijing Lisheng Cardiovascular Health Foundation (LHJJ20141751); Guangdong Provincial science and technology project (2020B1111170011, KJ022021049); Guangdong Provincial People's Hospital Foundation (DFJH201919), and Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention (No.Y0120220151). The work was not funded by any industry sponsors.

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Author notes

  1. Yihang Ling, Yibo He and Wei Guo have contributed equally.

Authors and Affiliations

  1. Department of Cardiology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China

    Yihang Ling, Sijia Yu, Haozhang Huang & Jiyan Chen

  2. Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China

    Yihang Ling, Yibo He, Zhidong Huang, Qiang Li, Jin Liu, Yong Liu & Jiyan Chen

  3. Guangdong Provincial Geriatrics Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China

    Wei Guo

  4. Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China

    Rongting Zhang & Yukun Zhao

  5. Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China

    Yong Liu & Jiyan Chen

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  1. Yihang Ling
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Contributions

YL, YH, SC, JC contributed to the study’s conception and design. WG, QL, SY, HH, RZ, ZH, JL contributed to literature search, studies screening and data extraction. YL, YH contributed to the analysis and the first draft of the manuscript. JC, YL, JL, SC commented on and revised the final versions of the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Yong Liu or Jiyan Chen.

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The authors have no relevant financial or non-financial interests to disclose.

Ethics approval

The study was approved by the institutional Ethics Research Committee of Guangdong Provincial People’s Hospital (No. GDREC2012141H).

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Written informed consent was obtained from all involved patients.

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Ling, Y., He, Y., Guo, W. et al. Association of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and acute kidney disease in patients undergoing coronary angiography: a cohort study. Int Urol Nephrol 55, 2067–2073 (2023). https://doi.org/10.1007/s11255-023-03491-7

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