Usefulness of Serum Brain Natriuretic Peptide as a Predictor Biomarker of Renal Artery Stenosis in Patients with Resistant Hypertension

Abstract

Aim: In this study, we aimed to evaluate the relationship between BNP level and RAS in patients with resistant hypertension according to the results of renal arteriography.   

Material and Methods: Forty patients with resistant hypertension were included to the study. In order to compare to each other regarding the BNP levels, the patients were evaluated by dividing them into groups as RAS (group1; non-critical (1a) and critical (1b)), non-RAS (group 2), unilateral RAS (non-critical (A) and critical (B)) and bilateral RAS (non-critical (C) and critical (D)) according to the results of renal arteriography.  

Results: The serum BNP (p=0.003) and serum creatinine (p=0.015) levels of group 1b were also significantly higher than group 1a. The patients in group B had higher serum BNP levels (p=0.025) and lower creatinine clearance levels (p=0.041) compared to group A. Higher serum creatinine (p=0.006), serum BNP levels (p=0.017) and lower creatinine clearance levels (p=0.049) have been observed in group D compared to group C.  

Conclusion: Findings of this study revealed that increased serum BNP levels were significantly associated with the severity of RAS determined by the results of renal arteriography. Thus BNP may be used as a predictive marker to detect the presence of RAS in patients with resistant hypertension. 

Keywords

• Brain natriuretic peptid,renal artery stenosis,resistant hypertension

Dirençli Hipertansiyonlu Hastalarda Serum Beyin Natriüretik Peptit Düzeylerinin Renal Arter Stenozunu Öngermede Bir Belirteç Olarak Kullanımı

Abstract

Amaç: Bu çalışmada dirençli hipertansiyon ön tanısıyla selektif renal arteriografisi yapılan ve renal arter stenozu (RAS) saptanan hastalarda serum beyin natriüretik peptit (BNP) düzeyleri ile RAS arasındaki ilişkiyi değerlendirmeyi amaçladık.  

Gereç ve Yöntemler: Dirençli hipertansiyonu olan 40  hasta bu çalışmaya alındı. Hastalar renal arter arteriografisi sonucuna göre RAS olan (Grup 1) ve olmayan (Grup 2) olmak üzere iki gruba ayrıldı. Renal arterde darlığı % 50’den az olanlar Grup 1a, diğerleri Grup 1b olarak kabul edildi. Unilateral non-kritik RAS tespit edilen hastalar Grup A, unilateral kritik RAS tespit edilenler Grup B, bilateral non-kritik RAS tespit edilenler Grup C ve bilateral kritik RAS tespit edilenler Grup D  olarak kabul edildi. Hasta grupları BNP düzeyleri açısından karşılaştırıldı.

Bulgular: Grup 1b hastalarda serum BNP ve serum kreatinin değerleri Grup 1a’ya göre daha yüksek saptandı (sırasıyla, p=0,003 ve p=0,015). Grup B hastaları A grubundakilere göre daha yüksek serum BNP düzeyleri ve daha düşük kreatinin klerensine sahiptiler (sırasıyla, p=0,025 ve p=0,041). Ayrıca D grubu hastalar C grubundakilerle karşılaştırıldığında yüksek serum BNP, kreatinin düzeyleri ve daha düşük kreatinin klerensine sahiptiler(sırasıyla, p=0,017,  p=0,006 ve p=0,049).

Sonuç: Çalışmamızın sonuçlarına göre yüksek serum BNP düzeylerinin renal anjiografi ile belirlenen RAS dereceleri ile anlamlı ilişkisi olduğunu göstermektedir. Bundan dolayı dirençli hipertansiyonu olan hastalarda RAS’ı tahmin etmede serum BNP düzeylerinin bir belirleyici olarak kullanılabilir.

Keywords

• Beyin natriüretik peptit,renal arter stenozu,dirençli hipertansiyon

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