Abstract

Background: Cardiac biomarkers N-terminal pro-B-type natriuretic peptide (NT-proBNP), cardiac troponin T (cTnT), hsCRP and Albuminuria, predicts underlying heart disease in the general population as
well as in CKD patients.

Objective: To study association of NT-proBNP, cTnT, hsCRP, spot urine albumin creatinine ratio with left ventricular mass index (LVMI) for cardiovascular risk prediction in predialysis CKD patients.

Methods: Cross section study included a total of 120 adult predialysis CKD patients. 40 patients in each predialysis CKD group of stage 3, 4 and 5 were taken. Serum cTnT, serum hsCRP, plasma NT-proBNP, single spot urine albumin creatinine ratio (UACR) were measured. Two-dimensional targeted M-mode Echocardiography was done to measure left ventricular mass index (LVMI).

Results: Mean values of Plasma NT-proBNP (pg/ml), Serum hs-CRP (mg/L), Spot UACR (mg/g of creatinine) and LVMI (g/m²) were 585.68±514.84, 5.96±2.52, 719.37±411.36, 134.92±21.71 respectively in predialysis CKD patients (n=120). Serum cTn-T level was increased in 40% of predialysis CKD patients. Among cardiovascular biomarkers plasma NT-proBNP was most strongly correlated (spearman's rho correlation coefficient; r=0.769 & p<0.0001) with the left ventricular mass index followed by spot urine albumin creatinine ratio (spearman's rho correlation coefficient; r=0.664 & p<0.0001), serum cTn-T (spearman's rho correlation coefficient; r=0.479 & p<0.0001) and serum hs-CRP (spearman's rho correlation coefficient; r=0.246 & p=0.007).

Conclusions: Cardiovascular biomarkers plasma NT-proBNP, serum cTnT, serum hs-CRP and UACR significantly correlate with LVMI. These can predict cardiovascular risk in a predialysis CKD population
with expected high cardiac morbidity and mortality.

Keywords: Novel cardiac biomarkers, spot urine albumin creatinine ratio, left ventricular mass index, predialysis CKD patients