ArticleArchives of medical science : AMS2018
The role of B-type natriuretic peptide in diagnosing acute decompensated heart failure in chronic kidney disease patients.
Article in Archives of medical science : AMS, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 12 citations in OpenAlex.
- Identification of key genes related to heart failure by analysis of expression profiles.Archives of medical science : AMS · 2024Article
- Development of a clinical risk score system for peritoneal dialysis-associated peritonitis treatment failure.BMC nephrology · 2023Article
- Educational Case: Evaluating a patient with cirrhosis.Academic pathology · 2022Article
- Detecting cardiomyopathies in pregnancy and the postpartum period with an electrocardiogram-based deep learning model.European heart journal. Digital health · 2021Article
- Are there any further modalities for prediction of subclinical volume overload in advanced stages of chronic kidney disease?Kidney research and clinical practice · 2021Article
- Length of stay and readmission in older adults hospitalized for heart failure.Archives of medical science : AMS · 2021Article
- Point-of-care ultrasound modalities in terms of diagnosing acute decompensated heart failure in emergency department; a diagnostic accuracy study.Internal and emergency medicine · 2020Article
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionChronic kidney disease (CKD) and congestive heart failure (CHF) patients have higher serum B-type natriuretic peptide (BNP), which alters the test interpretation. We aim to define BNP cutoff levels to diagnose acute decompensated heart failure (ADHF) in CKD according to CHF subtype: heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF). MATERIAL AND
methodsWe reviewed 1,437 charts of consecutive patients who were admitted for dyspnea. We excluded patients with normal kidney function, without measured BNP, echocardiography, or history of CHF. BNP cutoff values to diagnose ADHF for CKD stages according to CHF subtype were obtained for the highest pair of sensitivity (Sn) and specificity (Sp). We calculated positive and negative likelihood ratios (LR+ and LR-, respectively), and diagnostic odds ratios (DOR), as well as the area under the receiver operating characteristic curves (AUC) for BNP.
resultsWe evaluated a cohort of 348 consecutive patients: 152 had ADHF, and 196 had stable CHF. In those with HFpEF with CKD stages 3-4, BNP < 155 pg/ml rules out ADHF (Sn90%, LR- = 0.26 and DOR = 5.75), and BNP > 670 pg/ml rules in ADHF (Sp90%, LR+ = 4 and DOR = 6), with an AUC = 0.79 (95% CI: 0.71-0.87). In contrast, in those with HFrEF with CKD stages 3-4, BNP < 412.5 pg/ml rules out ADHF (Sn90%, LR- = 0.19 and DOR = 9.37), and BNP > 1166.5 pg/ml rules in ADHF (Sp87%, LR+ = 3.9 and DOR = 6.97) with an AUC = 0.78 (95% CI: 0.69-0.86). All LRs and DOR were statistically significant.
conclusionsBNP cutoff values for the diagnosis of ADHF in HFrEF were higher than those in HFpEF across CKD stages 3-4, with moderate discriminatory diagnostic ability.
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