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Horm Metab Res 2018; 50(05): 389-396
DOI: 10.1055/a-0603-3792
Endocrine Care
© Georg Thieme Verlag KG Stuttgart · New York

Relationship Between the Brain Natriuretic Peptide (BNP) Level and Prognosis of Diabetic Nephropathy with Microalbuminuria: A 7-Year Follow-Up Study

Naoto Seki
1   Department of Clinical Research, National Hospital Organization, Chiba-East National Hospital, Chiba, Japan
,
Tsuyoshi Matsumoto
2   Department of Internal Medicine, Japan Community Health Care Organization, Funabashi Central Hospital, Funabashi, Japan
,
Motoharu Fukazawa
2   Department of Internal Medicine, Japan Community Health Care Organization, Funabashi Central Hospital, Funabashi, Japan
› Author Affiliations
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Publication History

received 28 July 2017

accepted 05 April 2018

Publication Date:
03 May 2018 (online)

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Abstract

The aim of the study was to examine the relationship between the brain natriuretic peptide (BNP) level and prognosis of diabetic nephropathy. The subjects were 100 Japanese outpatients with type 2 diabetes mellitus with microalbuminuria. Associations between metabolic parameters at baseline, including BNP, and prognosis of diabetic nephropathy (progression of diabetic nephropathy, cardiovascular events, and death) were examined for 7 years. In Cox proportional hazard analysis, HbA1c, albumin-creatinine ratio (ACR) and BNP were identified as significant factors for progression of diabetic nephropathy (p=0.033, p=0.037, and p=0.044, respectively), BNP was identified as significant factor for cardiovascular events (p=0.046), and estimated glomerular filtration rate (eGFR) and BNP were identified as significant factors for death (p=0.046 and p=0.048, respectively). In Kaplan–Meier analysis, risks of progression of diabetic nephropathy, cardiovascular events, and death were significantly different between patients with a low and a high BNP level (p=0.046, p=0.002, and p=0.025, respectively). ROC curve analysis gave cutoff values for BNP of 14.9 pg/ml for progression of diabetic nephropathy, 16.3 pg/ml for cardiovascular events, and 17.6 pg/ml for death (p=0.047, p=0.035, p=0.018, respectively). In conclusion, the BNP level is associated with prognosis in diabetic nephropathy.

Key words

diabetic nephropathy - microalbuminuria - brain natriuretic peptide
 

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