Analysis on Plasma NT-proBNP Levels in Patients with Heart Failure and Chronic Renal Insufficiency

HU Xinke; WANG Jun; ZHANG Anning; WEN Fang; LIU Jinbo; WANG Hongyu

doi:10.12102/j.issn.1672-1349.2025.17.013

Abstract：Objective: To investigate the changes in serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels in patients with heart failure combined with chronic renal insufficiency, to provide a theoretical basis for guiding the clinical assessment of the severity of heart failure in these patients. Methods: A total of 252 hospitalized patients with heart failure (III or IV grade) diagnosed in the cardiology department of Beijing Tongren Hospital, Capital Medical University, Men Tou Gou Branch from June 2018 to January 2024 were selected as the study subjects. They were divided into a normal renal function group (70 cases, GFR ≥ 90 mL/min) and a renal insufficiency group (182 cases, GFR < 90 mL/min) based on glomerular filtration rate (GFR). The renal insufficiency group was further classified into mild (69 cases, 60-90 mL/min), moderate (65 cases, 30-60 mL/min), and severe (48 cases, <30 mL/min) groups according to GFR classification. Serum NT-proBNP levels were detected using the double-antibody immunoassay sandwich method, and left ventricular ejection fraction (LVEF) was obtained using M-mode echocardiography. Results: There was no statistically significant difference in serum NT-proBNP levels and LVEF between the mild renal insufficiency group and the normal renal function group (P > 0.05). In patients with moderate and severe renal insufficiency, serum NT-proBNP levels were higher than those in patients with normal renal function (P < 0.05), while LVEF was lower (P < 0.05). In patients with moderate and severe renal insufficiency, NT-proBNP levels were negatively correlated with GFR (P < 0.05). Conclusion: When there is mild renal impairment, the diagnostic cutoff value of NT-proBNP for heart failure does not need to be changed. However, when there is moderate or severe renal impairment, the current NT-proBNP standards cannot be used to assess the severity of heart failure, and the diagnostic threshold may need to be adjusted accordingly.