Abstract: FR-PO0518
B-Type Natriuretic Peptide (BNP) Association with CKD and AKI
Session Information
- CKM: Clinical - Trials, Epidemiology, and Biomarkers
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Cardiovascular-Kidney-Metabolic Health
- 602 Cardiovascular-Kidney-Metabolic Health: Clinical
Authors
- Fontanet-Gomez, Nicole C., BayCare Health System, Clearwater, Florida, United States
- Gutierrez-Silva, Jean Carlos, BayCare Health System, Clearwater, Florida, United States
Background
CKD is associated with a high risk of progression to kidney failure and AKI-related hospitalizations. BNP is a cardiac biomarker frequently elevated in CKD, and its routine monitoring has been proposed as a potential strategy to guide management and improve outcomes. However, whether routine BNP monitoring is associated with improved renal outcomes remains unclear. This study evaluated the association between BNP monitoring frequency and kidney-related outcomes in patients with CKD.
Methods
We conducted a retrospective cohort study of 800 adults with CKD within a single healthcare system. Patients were categorized as routine vs infrequent BNP monitoring based on testing frequency. The primary outcome was a composite of kidney failure progression, AKI-related hospitalization, or dialysis initiation. Baseline characteristics were compared between groups. Multivariable logistic regression assessed the association between BNP monitoring and the composite outcome. Time-to-event analyses used Kaplan-Meier curves and log-rank testing. Due to violation of the proportional hazards assumption, Cox models were stratified by monitoring status and adjusted for age, sex, comorbidities, baseline kidney function, diuretic use, and healthcare utilization.
Results
Among 800 patients, 296 composite outcome events occurred during follow up. Patients undergoing routine BNP monitoring demonstrated worse unadjusted event-free survival compared with those with infrequent monitoring (log-rankx2 = 10.1, p = 0.001). In multivariable analyses, lower baseline eGFR was strongly associated with increased risk of the composite outcome (HR 0.975 per unit increase, p < 0.001), and increasing age was independently associated with higher risk (HR1.008,p= 0.024). HF demonstrated a trend toward increased risk (HR1.27,p=0.058). Other covariates, including sex, DM, HTN, diuretic use, and healthcare utilization, were not significantly associated with outcomes. The proportional hazards assumption was satisfied in the stratified Cox model (global p = 0.94).
Conclusion
Routine BNP monitoring was linked to worse unadjusted outcomes in CKD, likely reflecting higher-risk patients being monitored more often. After adjustment, kidney function and age were the main predictors. BNP monitoring appears to mark disease severity rather than independently affect outcomes. Prospective studies are needed to determine whether BNP-guided management strategies can improve clinical outcomes in CKD.
Acknowledgment
The authors would like to acknowledge St. Joseph Hospital for its support and the use of its healthcare system data that made this study possible.