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European Journal of Heart Failure 2007 9(8):787-794; doi:10.1016/j.ejheart.2007.04.001
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© 2007 European Society of Cardiology

Anaemia and renal dysfunction are independently associated with BNP and NT-proBNP levels in patients with heart failure

Jochem Hogenhuisa, Adriaan A. Voorsa,*, Tiny Jaarsmaa, Arno W. Hoesb, Hans L. Hillegec, Johannes A. Kragtend and Dirk J. van Veldhuisena

a Department of Cardiology, Thoraxcenter, University Medical Centre Groningen, University of Groningen PO Box 30.001, 9700 RB Groningen, The Netherlands
b Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht Utrecht, The Netherlands
c Trial Coordination Centre, University Medical Centre Groningen, University of Groningen Groningen, The Netherlands
d Department of Cardiology, Atrium Medical Centre Heerlen, The Netherlands

* Corresponding author. Tel.: +0031 50 3611594. fax: +0031 50 3614391. E-mail address: a.a.voors{at}thorax.umcg.nl


  Abstract

Background: Anaemia may affect B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) levels, but this has not been well described in heart failure (HF) patients without the exclusion of patients with renal dysfunction.

Aims: To study the influence of both anaemia and renal function on BNP and NT-proBNP levels in a large group of hospitalised HF patients.

Methods and results: We studied 541 patients hospitalised for HF (mean age 71±11 years, 62% male, and left ventricular ejection fraction 0.33±0.14). Of these patients, 30% (n=159) were anaemic (women: Hb <7.5 mmol/l, men: Hb <8.1 mmol/l). Of the 159 anaemic patients, 73% had renal dysfunction (eGFR<60 ml/min/1.73 m2) and of the non-anaemic patients, 57% had renal dysfunction. BNP and NT-proBNP levels were measured in all patients before discharge. In multivariable analyses both plasma haemoglobin and eGFR were independently related to the levels of BNP and NT-proBNP (standardised beta's of –0.16, –0.14 [BNP] and –0.19, –0.26 [NT-proBNP] respectively, P-values<0.01).

Conclusion: Anaemia and renal dysfunction are related to increased BNP and NT-proBNP levels, independent of the severity of HF. These results indicate that both anaemia and renal dysfunction should be taken into consideration during the interpretation of BNP and NT-proBNP levels in HF patients.

Key Words: BNP • NT-proBNP • Heart failure • Anaemia • Renal dysfunction

Received August 16, 2006; Revised December 22, 2006; Accepted April 5, 2007


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