NT-ProBNP and troponin T and risk of rapid kidney function decline and incident CKD in elderly adults

Nisha Bansal, Ronit Katz, Lorien Dalrymple, Ian De Boer, Christopher Defilippi, Bryan Kestenbaum, Meyeon Park, Mark Sarnak, Stephen Seliger, Michael Shlipak, Michael Shlipak, Michael Shlipak, Michael Shlipak

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Background and objectives Elevations in N-terminal pro–B-type natriuretic peptide and high-sensitivity troponin T are associated with poor cardiovascular outcomes. Whether elevations in these cardiac biomarkers are associated with decline in kidney function was evaluated. Design, setting, participants, & measurements N-terminal pro–B-type natriuretic peptide and troponin T were measured at baseline in 3752 participants free of heart failure in the Cardiovascular Health Study. eGFR was determined from the Chronic Kidney Disease Epidemiology Collaboration equation using serum cystatin C. Rapid decline in kidney function was defined as decline in serum cystatin C eGFR$30%, and incident CKD was defined as the onset of serum cystatin C eGFR,60 among those without CKD at baseline (n=2786). Cox regression models were used to examine the associations of each biomarker with kidney function decline adjusting for demographics, baseline serum cystatin C eGFR, diabetes, and other CKD risk factors. Results In total, 503 participants had rapid decline in serum cystatin C eGFR over a mean follow-up time of 6.41 (1.81) years, and 685 participants developed incident CKD over a mean follow-up time of 6.41 (1.74) years. Participants in the highest quartile of N-terminal pro–B-type natriuretic peptide (.237 pg/ml) had an 67% higher risk of rapid decline and 38% higher adjusted risk of incident CKD compared with participants in the lowest quartile (adjusted hazard ratio for serum cystatin C eGFR rapid decline, 1.67; 95% confidence interval, 1.25 to 2.23; hazard ratio for incident CKD, 1.38; 95% confidence interval, 1.08 to 1.76). Participants in the highest category of troponin T (.10.58 pg/ml) had 80% greater risk of rapid decline compared with participants in the lowest category (adjusted hazard ratio, 1.80; 95% confidence interval, 1.35 to 2.40). The association of troponin T with incident CKD was not statistically significant (hazard ratio, 1.17; 95% confi- dence interval, 0.92 to 1.50). Conclusions ElevatedN-terminal pro–B-type natriuretic peptide and troponin T are associatedwith rapid decline of kidney function and incident CKD. Additional studies are needed to evaluate the mechanisms that may explain this association.

Original languageEnglish (US)
Pages (from-to)205-214
Number of pages10
JournalClinical Journal of the American Society of Nephrology
Volume10
Issue number2
DOIs
StatePublished - 2015

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Cystatin C
Troponin T
Natriuretic Peptides
Kidney
Serum
Confidence Intervals
Peptide T
Biomarkers
Chronic Renal Insufficiency
Proportional Hazards Models
Epidemiology
Heart Failure
Demography
Health

ASJC Scopus subject areas

  • Nephrology
  • Transplantation
  • Epidemiology
  • Critical Care and Intensive Care Medicine

Cite this

NT-ProBNP and troponin T and risk of rapid kidney function decline and incident CKD in elderly adults. / Bansal, Nisha; Katz, Ronit; Dalrymple, Lorien; De Boer, Ian; Defilippi, Christopher; Kestenbaum, Bryan; Park, Meyeon; Sarnak, Mark; Seliger, Stephen; Shlipak, Michael; Shlipak, Michael; Shlipak, Michael; Shlipak, Michael.

In: Clinical Journal of the American Society of Nephrology, Vol. 10, No. 2, 2015, p. 205-214.

Research output: Contribution to journalArticle

Bansal, N, Katz, R, Dalrymple, L, De Boer, I, Defilippi, C, Kestenbaum, B, Park, M, Sarnak, M, Seliger, S, Shlipak, M, Shlipak, M, Shlipak, M & Shlipak, M 2015, 'NT-ProBNP and troponin T and risk of rapid kidney function decline and incident CKD in elderly adults', Clinical Journal of the American Society of Nephrology, vol. 10, no. 2, pp. 205-214. https://doi.org/10.2215/CJN.04910514
Bansal, Nisha ; Katz, Ronit ; Dalrymple, Lorien ; De Boer, Ian ; Defilippi, Christopher ; Kestenbaum, Bryan ; Park, Meyeon ; Sarnak, Mark ; Seliger, Stephen ; Shlipak, Michael ; Shlipak, Michael ; Shlipak, Michael ; Shlipak, Michael. / NT-ProBNP and troponin T and risk of rapid kidney function decline and incident CKD in elderly adults. In: Clinical Journal of the American Society of Nephrology. 2015 ; Vol. 10, No. 2. pp. 205-214.
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abstract = "Background and objectives Elevations in N-terminal pro–B-type natriuretic peptide and high-sensitivity troponin T are associated with poor cardiovascular outcomes. Whether elevations in these cardiac biomarkers are associated with decline in kidney function was evaluated. Design, setting, participants, & measurements N-terminal pro–B-type natriuretic peptide and troponin T were measured at baseline in 3752 participants free of heart failure in the Cardiovascular Health Study. eGFR was determined from the Chronic Kidney Disease Epidemiology Collaboration equation using serum cystatin C. Rapid decline in kidney function was defined as decline in serum cystatin C eGFR$30{\%}, and incident CKD was defined as the onset of serum cystatin C eGFR,60 among those without CKD at baseline (n=2786). Cox regression models were used to examine the associations of each biomarker with kidney function decline adjusting for demographics, baseline serum cystatin C eGFR, diabetes, and other CKD risk factors. Results In total, 503 participants had rapid decline in serum cystatin C eGFR over a mean follow-up time of 6.41 (1.81) years, and 685 participants developed incident CKD over a mean follow-up time of 6.41 (1.74) years. Participants in the highest quartile of N-terminal pro–B-type natriuretic peptide (.237 pg/ml) had an 67{\%} higher risk of rapid decline and 38{\%} higher adjusted risk of incident CKD compared with participants in the lowest quartile (adjusted hazard ratio for serum cystatin C eGFR rapid decline, 1.67; 95{\%} confidence interval, 1.25 to 2.23; hazard ratio for incident CKD, 1.38; 95{\%} confidence interval, 1.08 to 1.76). Participants in the highest category of troponin T (.10.58 pg/ml) had 80{\%} greater risk of rapid decline compared with participants in the lowest category (adjusted hazard ratio, 1.80; 95{\%} confidence interval, 1.35 to 2.40). The association of troponin T with incident CKD was not statistically significant (hazard ratio, 1.17; 95{\%} confi- dence interval, 0.92 to 1.50). Conclusions ElevatedN-terminal pro–B-type natriuretic peptide and troponin T are associatedwith rapid decline of kidney function and incident CKD. Additional studies are needed to evaluate the mechanisms that may explain this association.",
author = "Nisha Bansal and Ronit Katz and Lorien Dalrymple and {De Boer}, Ian and Christopher Defilippi and Bryan Kestenbaum and Meyeon Park and Mark Sarnak and Stephen Seliger and Michael Shlipak and Michael Shlipak and Michael Shlipak and Michael Shlipak",
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T1 - NT-ProBNP and troponin T and risk of rapid kidney function decline and incident CKD in elderly adults

AU - Bansal, Nisha

AU - Katz, Ronit

AU - Dalrymple, Lorien

AU - De Boer, Ian

AU - Defilippi, Christopher

AU - Kestenbaum, Bryan

AU - Park, Meyeon

AU - Sarnak, Mark

AU - Seliger, Stephen

AU - Shlipak, Michael

AU - Shlipak, Michael

AU - Shlipak, Michael

AU - Shlipak, Michael

PY - 2015

Y1 - 2015

N2 - Background and objectives Elevations in N-terminal pro–B-type natriuretic peptide and high-sensitivity troponin T are associated with poor cardiovascular outcomes. Whether elevations in these cardiac biomarkers are associated with decline in kidney function was evaluated. Design, setting, participants, & measurements N-terminal pro–B-type natriuretic peptide and troponin T were measured at baseline in 3752 participants free of heart failure in the Cardiovascular Health Study. eGFR was determined from the Chronic Kidney Disease Epidemiology Collaboration equation using serum cystatin C. Rapid decline in kidney function was defined as decline in serum cystatin C eGFR$30%, and incident CKD was defined as the onset of serum cystatin C eGFR,60 among those without CKD at baseline (n=2786). Cox regression models were used to examine the associations of each biomarker with kidney function decline adjusting for demographics, baseline serum cystatin C eGFR, diabetes, and other CKD risk factors. Results In total, 503 participants had rapid decline in serum cystatin C eGFR over a mean follow-up time of 6.41 (1.81) years, and 685 participants developed incident CKD over a mean follow-up time of 6.41 (1.74) years. Participants in the highest quartile of N-terminal pro–B-type natriuretic peptide (.237 pg/ml) had an 67% higher risk of rapid decline and 38% higher adjusted risk of incident CKD compared with participants in the lowest quartile (adjusted hazard ratio for serum cystatin C eGFR rapid decline, 1.67; 95% confidence interval, 1.25 to 2.23; hazard ratio for incident CKD, 1.38; 95% confidence interval, 1.08 to 1.76). Participants in the highest category of troponin T (.10.58 pg/ml) had 80% greater risk of rapid decline compared with participants in the lowest category (adjusted hazard ratio, 1.80; 95% confidence interval, 1.35 to 2.40). The association of troponin T with incident CKD was not statistically significant (hazard ratio, 1.17; 95% confi- dence interval, 0.92 to 1.50). Conclusions ElevatedN-terminal pro–B-type natriuretic peptide and troponin T are associatedwith rapid decline of kidney function and incident CKD. Additional studies are needed to evaluate the mechanisms that may explain this association.

AB - Background and objectives Elevations in N-terminal pro–B-type natriuretic peptide and high-sensitivity troponin T are associated with poor cardiovascular outcomes. Whether elevations in these cardiac biomarkers are associated with decline in kidney function was evaluated. Design, setting, participants, & measurements N-terminal pro–B-type natriuretic peptide and troponin T were measured at baseline in 3752 participants free of heart failure in the Cardiovascular Health Study. eGFR was determined from the Chronic Kidney Disease Epidemiology Collaboration equation using serum cystatin C. Rapid decline in kidney function was defined as decline in serum cystatin C eGFR$30%, and incident CKD was defined as the onset of serum cystatin C eGFR,60 among those without CKD at baseline (n=2786). Cox regression models were used to examine the associations of each biomarker with kidney function decline adjusting for demographics, baseline serum cystatin C eGFR, diabetes, and other CKD risk factors. Results In total, 503 participants had rapid decline in serum cystatin C eGFR over a mean follow-up time of 6.41 (1.81) years, and 685 participants developed incident CKD over a mean follow-up time of 6.41 (1.74) years. Participants in the highest quartile of N-terminal pro–B-type natriuretic peptide (.237 pg/ml) had an 67% higher risk of rapid decline and 38% higher adjusted risk of incident CKD compared with participants in the lowest quartile (adjusted hazard ratio for serum cystatin C eGFR rapid decline, 1.67; 95% confidence interval, 1.25 to 2.23; hazard ratio for incident CKD, 1.38; 95% confidence interval, 1.08 to 1.76). Participants in the highest category of troponin T (.10.58 pg/ml) had 80% greater risk of rapid decline compared with participants in the lowest category (adjusted hazard ratio, 1.80; 95% confidence interval, 1.35 to 2.40). The association of troponin T with incident CKD was not statistically significant (hazard ratio, 1.17; 95% confi- dence interval, 0.92 to 1.50). Conclusions ElevatedN-terminal pro–B-type natriuretic peptide and troponin T are associatedwith rapid decline of kidney function and incident CKD. Additional studies are needed to evaluate the mechanisms that may explain this association.

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