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The Kidney in Heart Failure pp 67–77Cite as

B-Type Natriuretic Peptide: Beyond Diagnostic Applications

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Abstract

B-type natriuretic peptides (BNPs) are produced by the heart and reflect the determinants of ventricular wall tension. Because they have some degree of renal elimination, moderate elevations in BNP and NT-proBNP are expected when the eGFR falls below 60 mL/min. Virtually, all patients on hemodialysis have markedly elevated BNP. The potential roles of BNPs in cardiorenal syndromes include: (1) early detection or risk prediction before a rise in serum creatinine is observed, (2) diagnostic aid in the detection of HF in patients with acute dyspnea and renal dysfunction, (3) prognosis for all-cause death in HF with or without CKD, (4) management of patients with established HF, possibly including those with chronic cardiorenal syndromes. Acute and chronic heart and/or renal dysfunction can occur in any combination and likely share many pathologic mechanisms. Additional studies are therefore needed to further establish the utility of BNPs in each of the five cardiorenal syndromes and to understand their relationships between not only measures of renal filtration but also markers of acute kidney injury and clinical outcomes.

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Author information

Authors and Affiliations

  1. Divisions of Cardiology, Nutrition and Preventive Medicine, Department of Medicine, William Beaumont Hospital, Royal Oak, MI, USA

    Ivan D. Hanson

  2. Department of Medicine, Division of Cardiology, St. John Hospital and Medical Center Detroit, Providence Hospitals and Medical Centers, Southfield and Novi, 47601 Grand River Avenue, Suite B-125, Novi, MI, 48374, USA

    Peter A. McCullough

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  1. Ivan D. Hanson
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  2. Peter A. McCullough
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Correspondence to Peter A. McCullough .

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Editors and Affiliations

  1. ASH Comprehensive Hypertension Center, Department of Medicine, University of Chicago Medical Center, 5841 S. Maryland Avenue, MC1027, Chicago, 60637, Illinois, USA

    George L. Bakris

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Hanson, I.D., McCullough, P.A. (2012). B-Type Natriuretic Peptide: Beyond Diagnostic Applications. In: Bakris, G. (eds) The Kidney in Heart Failure. Springer, Boston, MA. https://doi.org/10.1007/978-1-4614-3694-2_6

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  • DOI: https://doi.org/10.1007/978-1-4614-3694-2_6

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