Natriuretic Peptides as Biomarkers for Congestive States: The Cardiorenal Divergence. Dis Markers 2017;2017:1454986
Date
07/14/2017Pubmed ID
28701807Pubmed Central ID
PMC5494089DOI
10.1155/2017/1454986Scopus ID
2-s2.0-85021865974 (requires institutional sign-in at Scopus site) 21 CitationsAbstract
Congestion represents the primary reason for hospitalization of patients with heart failure and is associated with adverse outcomes. Fluid overload has been shown to be inadequately addressed in a significant subset of these patients in part due to lack of robust, reliable, and readily available biomarkers for objective assessment and monitoring of therapy. Natriuretic peptides have long been used in this setting, often in conjunction with other assessment tools such as imaging studies. Patients presenting with concomitant cardiac and renal dysfunction represent a unique population with regard to congestion in that the interactions between the heart and the kidney can affect the utility and performance of biomarkers of fluid overload. Herein, we provide an overview of the currently available evidence on the utility of natriuretic peptides in these patients and discuss the clinical conundrum associated with their use in the setting of renal dysfunction. We highlight the potential divergence in the role of natriuretic peptides for assessment of volume status in a subset of patients with renal dysfunction who receive renal replacement therapy and call for future research to elucidate the utility of the biomarkers in this setting.
Author List
Koratala A, Kazory AAuthor
Abhilash Koratala MD Associate Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AgedAtrial Natriuretic Factor
Biomarkers
Female
Heart Failure
Humans
Kidney
Male
Middle Aged
Myocardium
Natriuretic Peptide, Brain
Natriuretic Peptide, C-Type
Prognosis
Renal Insufficiency
Renal Replacement Therapy
