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Abstract: SA-PO367

Association Between N-Terminal pro-B-Type Natriuretic Peptide with CKD Progression in the CKD in Children Cohort

Session Information

  • Pediatric Nephrology - III
    November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

  • 1900 Pediatric Nephrology

Authors

  • Kula, Alexander J., Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois, United States
  • Prince, David K., University of Washington, Seattle, Washington, United States
  • Flynn, Joseph T., Seattle Children's Hospital, Seattle, Washington, United States
  • Bansal, Nisha, University of Washington, Seattle, Washington, United States
Background

Elevations in the serum biomarker N-terminal pro B-type natriuretic peptide (NT-proBNP) are strongly associated with CKD progression in adults. It is unknown whether these associations are also seen in children with CKD, and may help identify a novel risk factor in this population. The objective of this study was to examine the association of NT-proBNP with CKD progression in youth with mild to moderate CKD.

Methods

We measured serum NT-proBNP at the baseline visit of participants with available samples enrolled in the Chronic Kidney Disease in Children (CKiD) study (N=493). Included participants were aged 1-18 years with an eGFR of 30-90mL/min/1.73m2. Exclusion criteria included history of kidney transplant, dialysis < 3 months, or structural heart disease. CKD progression was defined as a 40% decline in eGFR and/or progression to ESKD. We utilized nested Cox proportional hazards models to test the association between baseline NT-proBNP with CKD progression.

Results

Mean ±SD baseline NT-proBNP and eGFR were 127 ±173pg/mL and. 55 ±21mL/min/1.73m2, respectively. Median duration of follow-up was 3.9 years and 107 (22%) met criteria for CKD progression. In unadjusted models, NT-proBNP was associated with CKD progression (HR, [95% CI] per doubling: 1.36, [1.18, 1.56]). NT-proBNP was not associated with CKD progression in adjusted models (HR, [95% CI] per doubling: 1.06 [0.87, 1.29]). There was no interaction for participants with an eGFR above or below 45mL/min/1.73m2 (p= 0.84). Absolute and relative decline in eGFR was not different across baseline quartiles (Figure 1).

Conclusion

Unlike adults with CKD, NT-proBNP was not associated with CKD progression in a large, well-characterized cohort of youth with CKD. Potential explanations include physiologic differences across the lifespan and/or relatively short duration of follow-up.

Funding

  • Private Foundation Support