Heart failure & cardiomyopathies
Determining kidney function-specific thresholds for N-terminal pro-B-type natriuretic peptide in heart failure risk prediction among patients with chronic kidney disease: a multicentre, observational, cohort study
Authors' conclusion
In patients with CKD, NT-proBNP levels must be interpreted in the context of kidney function, as eGFR-specific thresholds provide superior HF risk stratification. These findings support adopting kidney function-adjusted thresholds rather than a uniform cut-off to improve HF risk prediction.
Study context
- Population
- Patients with chronic kidney disease (CKD) without prior heart failure (HF), China Renal Data Systempatients with CKD without prior HF
- Participants
- 18,261 patients
- Exposure
- Estimated glomerular filtration rate (eGFR)-specific thresholds vs uniform threshold
- Outcome
- Elevated NT-proBNP
Main finding
As reported in the abstract
Observational data: associations, not effects.
Further findings
Optimal NT-proBNP thresholds by kidney function
- Optimal NT-proBNP thresholds increased with declining kidney function, reaching the highest level in stage 5 CKD (eGFR <15 mL/min/1.73 m²)
HF risk prediction (Net Reclassification Improvement (NRI))
- NRI gains with eGFR-specific thresholds across stages 1 to 5
- 19% to 55%
- Uniform threshold added no predictive value for patients with stage 5 CKD
Original publication
Determining kidney function-specific thresholds for N-terminal pro-B-type natriuretic peptide in heart failure risk prediction among patients with chronic kidney disease: a multicentre, observational, cohort study. Heart. Published 26 February 2025. doi:10.
Summarised from the published abstract; every number is checked against it