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Horm Metab Res 2015; 47(02): 138-144
DOI: 10.1055/s-0034-1395530
Endocrine Care
© Georg Thieme Verlag KG Stuttgart · New York

Relationship Between the Brain Natriuretic Peptide (BNP) Level and Remission of Diabetic Nephropathy with Microalbuminuria: A 3-Year Follow-Up Study

N. Seki
1   Clinical Research Center, National Hospital Organization, Chiba-East National Hospital, Chiba, Japan
,
T. Matsumoto
2   Department of Internal Medicine, Social Insurance Funabashi Central Hospital, Funabashi, Japan
,
M. Fukazawa
2   Department of Internal Medicine, Social Insurance Funabashi Central Hospital, Funabashi, Japan
› Author Affiliations
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Publication History

received 20 March 2014

accepted after secondrevision 22 October 2014

Publication Date:
19 November 2014 (online)

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Abstract

The aim of the study was to examine the relationship between the brain natriuretic peptide (BNP) level and progression or remission of diabetic nephropathy with microalbuminuria for 3 years. The subjects were 100 Japanese type 2 diabetes mellitus outpatients with microalbuminuria. Associations between metabolic parameters at baseline [HbA1c, systolic blood pressure (SBP), urine albumin-creatinine ratio (ACR), estimated glomerular filtration rate (eGFR), and BNP] and the progression or remission of diabetic nephropathy were examined for 3 years. A total of 83 patients were examined at the end of the 3-year period, including 17 with remission to normoalbuminuria, 47 with continuing microalbuminuria, and 19 with progression to macroalbuminuria. HbA1c, ACR, and BNP differed significantly among the 3 groups (p=0.024, p<0.001, p=0.002, respectively). Among baseline factors, HbA1c and BNP were significant predictors of the percentage increase in ACR for 3 years in multiple linear regression analysis (β=0.259, p=0.02; β=0.299, p=0.007, respectively). In multivariate logistic regression analysis, HbA1c and ACR were independently associated with progression of diabetic nephropathy (p=0.008, p=0.023, respectively), and ACR and BNP were independently associated with remission of diabetic nephropathy (p=0.029, p=0.012, respectively). ROC curve analysis gave a cutoff value for BNP of 14.9 pg/ml for prediction of remission of diabetic nephropathy (p=0.016). The BNP level has a relationship with diabetic nephropathy and a low BNP level predicts remission of diabetic nephropathy. Therefore, monitoring of BNP can play an important role in management of diabetic nephropathy.

Key words

diabetic nephropathy - microalbuminuria - brain natriuretic peptide
 

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