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Erschienen in: Heart and Vessels 3/2017

06.07.2016 | Original Article

Brain natriuretic peptide as a potential novel marker of salt-sensitivity in chronic kidney disease patients without cardiac dysfunction

verfasst von: Mutsuharu Hayashi, Yoshinari Yasuda, Susumu Suzuki, Manaka Tagaya, Takehiro Ito, Tomohito Kamada, Masataka Yoshinaga, Yoshinori Sugishita, Wakaya Fujiwara, Hiroatsu Yokoi, Yukio Ozaki, Hideo Izawa

Erschienen in: Heart and Vessels | Ausgabe 3/2017

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Abstract

Although the renin–angiotensin system (RAS) is counter-balanced by a salt-sensitive mechanism in the hypertensive state, both are reported to be up-regulated in chronic kidney disease (CKD) patients. We conducted this study to evaluate the associations among the RAS, renal function, hypertension, and atherosclerosis, as well as to identify markers for salt-sensitivity. A total of 213 pre-dialysis CKD patients with preserved cardiac function (EF >50 %) were enrolled. Their renal and cardiac biochemical markers and plasma renin activity (PRA) were measured, and echocardiography and carotid artery ultrasound were performed. Their salt intake was estimated by the NaCl excretion from a 24-h collected urine sample. The PRA was higher in patients with hypertension (p = 0.018), and had a significant negative correlation with the eGFR (r = −0.23, p = 0.0067). Importantly, the PRA had a strong negative correlation with the brain natriuretic peptide (BNP) level (r = −0.28, p = 0.017) regardless of whether the patients were being treated with RAS inhibitors. The BNP level was related to the renal functions (eGFR: p = 0.001, ACR: p = 0.009). There was a significant positive correlation between the BNP level and carotid intima–media thickness (p < 0.001). A multivariate analysis revealed that older age and an excess of NaCl excretion were independent predictors of BNP elevation (p = 0.02 and 0.003, respectively). Our analysis revealed details of the counterbalance between BNP and PRA, as well as identifying that excess salt intake is a predictor of BNP elevation. These results indicate that the BNP could be a possible valuable marker for salt sensitivity, and that high salt sensitivity could facilitate atherosclerosis in CKD patients.
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Metadaten
Titel
Brain natriuretic peptide as a potential novel marker of salt-sensitivity in chronic kidney disease patients without cardiac dysfunction
verfasst von
Mutsuharu Hayashi
Yoshinari Yasuda
Susumu Suzuki
Manaka Tagaya
Takehiro Ito
Tomohito Kamada
Masataka Yoshinaga
Yoshinori Sugishita
Wakaya Fujiwara
Hiroatsu Yokoi
Yukio Ozaki
Hideo Izawa
Publikationsdatum
06.07.2016
Verlag
Springer Japan
Erschienen in
Heart and Vessels / Ausgabe 3/2017
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-016-0867-1

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