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Critical Care

, 23:341 | Cite as

NT-proBNP levels might predict outcomes in severe sepsis, but renal function cannot be ignored

  • Jiarong Ye
  • Qianrong Liang
  • Xiaotu XiEmail author
Open Access
Letter

We read with great interest the article by Carlo Custodero et al. recently published in Critical Care [1]. The authors concluded that NT-proBNP levels during the acute phase of sepsis may be a useful indicator of higher risk of long-term impairments in physical function and muscle strength in sepsis survivors. However, the article overlooks the association of NT-proBNP and renal function in septic patients. Studies have shown that acute kidney injury is a common complication of sepsis and is significantly associated with mortality [2, 3], whereas the studies by Gergei et al. [4] and Roberts et al. [5] indicated that NT-proBNP plasma level has shown an exponential increase with declining glomerular filtration rate. Thus, it did not seem persuasive that NT-proBNP could completely predict outcomes without adjusting for the covariate of renal function. We suggest the relationship of the NT-proBNP levels during the acute phase of sepsis and physical function and muscle strength outcomes in sepsis survivors be stratified based on the renal function.

Notes

Acknowledgements

None.

Authors’ contributions

JRY and XTX designed the paper. QRL edited the English text of a draft of this manuscript. All authors participated in the drafting and reviewing. All authors read and approved the final version of the manuscript.

Funding

None.

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

References

  1. 1.
    Custodero C, Wu Q, Ghita GL, Anton SD, Brakenridge SC, Brumback BA, et al. Prognostic value of NT-proBNP levels in the acute phase of sepsis on lower long-term physical function and muscle strength in sepsis survivors. Crit Care. 2019;23(1):230.CrossRefGoogle Scholar
  2. 2.
    Ma S, Evans RG, Iguchi N, Tare M, Parkington HC, Bellomo R, et al. Sepsis-induced acute kidney injury: a disease of the microcirculation. Microcirculation. 2019;26(2):e12483.CrossRefGoogle Scholar
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    Kellum JA, Wen X, de Caestecker MP, Hukriede NA. Sepsis-Associated Acute Kidney Injury: A Problem Deserving of New Solutions. Nephron. 2019:1–5.  https://doi.org/10.1159/000500167.CrossRefGoogle Scholar
  4. 4.
    Gergei I, Kramer BK, Scharnagl H, Stojakovic T, Marz W. Renal function, N-terminal pro-B-type natriuretic peptide, propeptide big-endothelin and patients with heart failure and preserved ejection fraction. Peptides. 2019;111:112–7.CrossRefGoogle Scholar
  5. 5.
    Roberts MA, Srivastava PM, Hare DL, Ierino FL. Effect of haemodialysis and residual renal function on serum levels of galectin-3, B-type natriuretic peptides and cardiac troponin T. Nephrology. 2018;23(12):1131–8.CrossRefGoogle Scholar

Copyright information

© The Author(s). 2019

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Authors and Affiliations

  1. 1.The Second Affiliated Hospital of Guangzhou University of Chinese Medicine and Guangdong Provincial Hospital of Chinese MedicineGuangzhouChina
  2. 2.Guangdong University of Foreign StudiesGuangzhouChina

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