Changes in Natriuretic Peptide Levels and Subsequent Kidney Function Decline in SPRINT

Novel approaches to the assessment of kidney disease risk during hypertension treatment are needed because of the uncertainty of how intensive blood pressure (BP) lowering impacts kidney outcomes. We determined whether longitudinal N-terminal pro–B-type natriuretic peptide (NT–proBNP) measurements during hypertension treatment are associated with kidney function decline. Prospective observational study. 8,005 SPRINT (Systolic Blood Pressure Intervention Trial) participants with NT–proBNP measurements at baseline and 1 year. 1-year change in NT–proBNP categorized as a ≥25% decrease, ≥25% increase, or 0.2 for interactions). Persons with diabetes and proteinuria >1 g/d were excluded. Changes in NT–proBNP during BP treatment are independently associated with subsequent kidney function decline, particularly in people with CKD. Future studies should assess whether routine NT–proBNP measurements may be useful in monitoring kidney risk during hypertension treatment. N-terminal pro–B-type natriuretic peptide (NT–proBNP) is a biomarker in the blood that reflects mechanical stress on the heart. Measuring NT–proBNP may be helpful in assessing the risk of long-term losses of kidney function. In this study, we investigated the association of changes in NT–proBNP with subsequent kidney function among individuals with and without chronic kidney disea