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Natriuretic peptides for early prediction of acute kidney injury in community-acquired pneumonia

Nowak, A. and Breidthardt, T. and Dejung, S. and Christ-Crain, M. and Bingisser, R. and Drexler, B. and Meune, C. and Marono, D. and Mosimann, T. and Muller, B. and Muller, C.. (2013) Natriuretic peptides for early prediction of acute kidney injury in community-acquired pneumonia. Clinica Chimica Acta, 419. pp. 67-72.

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Official URL: http://edoc.unibas.ch/56864/

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Abstract

BACKGROUND: Community-acquired pneumonia (CAP) is common and associated with a considerable risk of acute kidney injury (AKI). METHODS: We prospectively enrolled 341 patients presenting to the emergency department with CAP (mean age 72, male 61%). Blinded measurements of three natriuretic peptides (NT-proBNP, MR-proANP and BNP) were performed upon presentation. The primary endpoint was the accuracy of the natriuretic peptides to predict AKI within 48h. RESULTS: AKI occurred in 24 patients (7.6%) within the first 48h. NPs and creatinine were significantly higher in AKI compared with patients without AKI (NT-proBNP 9517 [2042-26,792] vs 1177 [280-4167]pg/ml; MR-proANP 641 [196-1075] vs 182 [99-352]pmol/l; BNP 592 [230-1630] vs 160 [64-463]pg/ml; creatinine 166 [131-289] versus 100 [78-134] mumol/l, P>0.001 for each). Predictive accuracy as quantified by the area under the receiver operating characteristics curve was moderate to high: NT-proBNP 0.79 (95%CI 0.70-0.88), MR-proANP 0.78 (95%CI 0.67-0.88), BNP 0.74 (95%CI 0.63-0.85), creatinine 0.77 (95%CI 0.66-0.88). In multivariate logistic regression analysis, NPs remained the only independent AKI predictors: NT-proBNP (increase of 200 pg/ml) OR=1.01, 95%CI 1.00-1.01, P=0.009; MR-proANP (increase of 100 pg/ml) OR=1.23, 95%CI 1.09-1.39, P=0.001; BNP (increase of 100 pg/ml) OR=1.08, 95%CI 1.03-1.14, P=0.002. CONCLUSIONS: NP levels are significantly elevated in CAP-patients experiencing early AKI. Their potential to predict early AKI is comparable to serum creatinine and might be useful in cases of diagnostic uncertainty.
Faculties and Departments:03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Allgemeine innere Medizin AG > Argovia Professur für Medizin (Müller)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Allgemeine innere Medizin AG > Argovia Professur für Medizin (Müller)
UniBasel Contributors:Müller, Beat
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Elsevier
ISSN:0009-8981
e-ISSN:1873-3492
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:01 Dec 2017 08:46
Deposited On:01 Dec 2017 08:46

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