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The following is a summary of “Prognostic Value of Natriuretic Peptide Levels for Adverse Renal Outcomes in Patients With Moderate to Severe Acute Kidney Injury With or Without Heart Failure,” published in the October 2023 issue of Cardiology by Chaikijurajai et al.
Natriuretic peptides are recognized as significant biomarkers in diagnosing and predicting outcomes for heart failure patients and often show elevated levels in acute kidney injury situations. This study aimed to establish connections between elevated baseline NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide) levels and adverse renal outcomes among individuals experiencing moderate-to-severe acute kidney injury.
Conducted at the Cleveland Clinic from September 2011 to December 2021, this retrospective analysis examined the electronic health records of consecutive patients diagnosed with acute kidney injury stages 2 and 3. The study focused on patients with documented NT‐proBNP levels before renal consultation or initiating dialysis. Adverse renal outcomes assessed included the need for dialysis and dialysis dependence, defined as patients requiring dialysis within 72 hours before discharge or experiencing in-hospital mortality. Among the 3,811 patients reviewed, 66% underwent dialysis, 42% became dialysis dependent, and 35% experienced in-hospital mortality. After accounting for cardiorenal risk factors, the study found that compared to the lowest quartile, the highest quartile of NT‐proBNP (≥18,215 pg/mL) was associated with significantly increased odds of requiring dialysis (adjusted odds ratio [OR] 2.36 [95% CI, 1.87–2.99]), dialysis dependence (adjusted OR 1.89 [95% CI, 2.53–1.34]), and in-hospital mortality (adjusted OR 1.34 [95% CI, 1.01–1.34]).
This investigation underscores the correlation between elevated NT‐proBNP levels and heightened risks of dialysis necessity, becoming dialysis dependent, and in-hospital mortality in individuals experiencing moderate-to-severe acute kidney injury.