Evaluation of Brain Natriuretic Peptide Hormone and Cardiac Troponin- T Levels among Patients with Chronic Kidney Disease and their Association with Cardiovascular Disease in Khartoum State, Sudan
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Date
2021
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جامعة الشيخ عبدالله البدري
Abstract
Abstract: Background: The danger of chronic kidney disease (CKD) is rising quickly worldwide and has become a
main health crisis and most of these patients die from cardiovascular disease (CVD) prior to progression to end stage
renal disease (ESRD), therefore, Poor cardiovascular outcomes in CKD patients have encouraged nephrologists to
search for biomarkers that may improve risk stratification in this population. The aim of this study was to assess serum
brain natriuretic peptide (BNP) hormone and cardiac troponin T (cTnT) levels in CKD patients and to determine their
involvement with cardiovascular diseases. Methods: This analytical case control study was conducted at Ibn sina and
Military hospitals in the period from February 2016 to March 2019, (n = 150) clinically diagnosed CKD patients (age
range between 22 - 76 years, 105 males and 45 females), and (n = 150) healthy subjects were included as controls.
Serum BNP hormone and cardiac troponin T (cTnT), were estimated by Cobas E-411®
fully automated analyzer, serum
creatinine by Cobas C-311®
fully automated analyzer, hemoglobin by Sysmix, glomerular filtration rate (GFR) was
calculated by Cocroft-Gault formula and blood pressure was measured by using mercuric sphygmomanometer. Results:
Serum BNP, cTnT, creatinine, systolic blood pressure (SBP), diastolic blood pressure (DBP) and body mass index
(BMI) were significantly higher in CKD patients than in controls, while hemoglobin and GFR were significantly lower.
Moreover, serum BNP, cTnT, SBP and DBP were significantly higher in CKD patients with cardiovascular disease
(CVD) than CKD patients without CVD. In addition, serum BNP, at cutoff level of 240 pg/ml, the sensitivity,
specificity, positive predictive value (PPV) and negative predictive value (NPV) were 87%, 90%, 52% and 92%,
respectively in relation to CVD, while serum cTnT, at cutoff level of 0.1 ng/ml, the sensitivity, specificity, PPV and
NPV were 80%, 57%, 46% and 74%, respectively. Furthermore, there was an association between elevated BNP levels
and CVD outcomes in patients with CKD, since it is a strong risk factor for CVD (OR: 1.48, p. value 0.031).
Conclusions: BNP levels are significantly associated with cardiovascular events (left ventricular hypertrophy and
systolic dysfunction) in patients who have CKD and are on maintenance hemodialysis (HD).