Elevated Brain Natriuretic Peptide Is Associated with Abnormal Heart Geometry in Children with Chronic Kidney Disease

Aim: It was to establish whether brain natriuretic peptide (BNP) might predict cardiac dysfunction in children with chronic kidney disease (CKD). Methods: The relation between BNP, echocardiography and risk factors (hypertension, anemia, lipids, CRP, hyperparathyroidism) was investigated in 46 children (10 pre-dialysis patients, 14 on dialysis, 11 children with kidney transplants, and 11 healthy controls). Data on BNP were transformed into common logarithms (log 10 BNP, log BNP). Results: log BNP was significantly higher in dialysis patients when compared to controls (2.09 ± 0.78 vs. 1.43 ± 0.34 pg/ml, p = 0.012) and patients in the pre-dialysis stage (2.09 ± 0.78 vs. 1.52 ± 0.42 pg/ml, p = 0.039). log BNP in transplanted children was not significantly different from healthy children (2.09 ± 0.78 vs. 1.71 ± 0.46 pg/ml, p = 0.19). Abnormal heart geometry (concentric and eccentric hypertrophy, concentric remodeling) was found in 19 patients (54.28%). A significant correlation was observed between log BNP and ventricular hypertrophy (r = 0.515, p = 0.001). Compared to controls higher log BNP was seen in children with eccentric hypertrophy than in children with concentric hypertrophy (2.178 ± 0.956 vs. 1.496 ± 0.395 pg/ml, p = 0.05, or 1.982 ± 0.618 vs. 1.496 ± 0.395, p = 0.04). Conclusions: BNP might predict an abnormal geometry in children with CKD.