Urine measurement indicates the plasma brain natriuretic peptide concentration during optimization of heart failure treatment |
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Authors: | Robert G Hahn Tiny Jaarsma Nana Waldréus Gerard C M Linssen |
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Institution: | 1. Department of Research, S?dert?lje Sjukhus, S?dert?lje, Sweden;2. r.hahn@telia.com Robert.hahn@sodertaljesjukhus.se;4. Department of Social and Welfare Studies, Faculty of Health Sciences, Link?ping University, Link?ping, Sweden;5. Department of Social and Welfare Studies, Faculty of Health Sciences, Link?ping University, Link?ping, Sweden;6. Department of Cardiology, Hospital Group Twente, Almelo, the Netherlands |
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Abstract: | Aim: To assess the correlation between the amino-terminal pro-hormone brain natriuretic peptide (NT-proBNP) concentration in blood and urine during a period when actively adjusting the treatment of heart failure (HF). Methods: Plasma and urine analyses of NT-proBNP were compared in 51 patients on admission to and discharge from a nurse-led outpatient clinic where HF treatment was optimized. The median time between the two measurements was 42 days. Correlations were analyzed using linear regression, where R2 is the degree of variability in the plasma NT-proBNP concentration that can be accounted for by the urinary NT-proBNP. Results: There was a statistically significant linear relationship between the urine and plasma concentrations of NT-proBNP on both occasions, but R2 varied greatly depending on how the data were presented. The correlation between the raw data showed an R2 of only 30%, and it almost doubled upon logarithm transformation, which shows that the variability (error) was concentration-dependent. Correction of the urinary NT-proBNP for urinary creatinine further increased R2 for the logarithm-transformed correlation to 68% on admission and 76% on discharge. The highest R2 (77%) was obtained when the relative changes in urinary NT-proBNP/creatinine between admission and discharge were compared with the corresponding relative changes in the plasma concentration. The sensitivity and specificity of the urine in indicating plasma concentration changes?>?10% were 82% and 86%, respectively. Conclusion: Relative changes in plasma NT-proBNP could be reliably estimated from urine samples during a period of optimization of HF treatment. |
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Keywords: | Heart failure urinary NT-proBNP natriuretic peptide brain patient monitoring |
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