Effect of azotemia on serum N-terminal proBNP concentration in dogs with normal cardiac function: A pilot study

To evaluate amino-terminal pro-B type natriuretic peptide (NT-proBNP) concentration in dogs with renal dysfunction and normal cardiac structure and function. Eight dogs with renal disease, 23 healthy control dogs. Serum NT-proBNP concentration was measured in healthy dogs and dogs with renal disease using an ELISA validated for use in dogs. Affected dogs were eligible for inclusion if renal dysfunction was diagnosed based on urinalysis and serum chemistry, and if they were free of cardiovascular disease based on physical exam, systolic blood pressure, and echocardiography. The geometric mean serum NT-proBNP concentration was significantly higher in dogs with renal disease (617 pmol/L; 95% CI, 260–1467 pmol/L) than in healthy control dogs (261 pmol/L; 95% CI, 225–303 pmol/L; P = 0.0014). There was a modest positive correlation between NT-proBNP and BUN and creatinine. Median NT-proBNP concentration was not significantly different between groups when indexed to BUN (median NT-proBNP:BUN ratio; renal, 14.2, IQR, 3.93–17.7 vs. control, 16.3, IQR, 9.94–21.2; P = 0.29) or creatinine (median NT-proBNP:creatinine ratio; renal, 204, IQR, 72.6–448 vs. control, 227, IQR, 179–308; P = 0.67). Dogs with renal disease had significantly higher mean serum concentration of NT-proBNP than control dogs. Renal function should be considered when interpreting NT-proBNP results as concentrations may be falsely elevated in dogs with renal dysfunction and normal cardiac function. The effect of renal disease was lessened by indexing NT-proBNP to BUN or creatinine. Future studies in dogs with both renal and heart disease are warranted.