How reliable is the measurement of serum brain natriuretic peptide in patients with CKD?
Like serum troponin, serum levels of brain natriuretic peptide are elevated in patients with CKD; in many cases, marked elevations are noted.
The magnitude of increase in serum brain natriuretic peptide depends on the degree of left ventricular hypertrophy and/or left ventricular systolic dysfunction. It is unclear if serum brain natriuretic peptide can be used to diagnose circulatory congestion in patients with CKD or to serially monitor response to diuretics or ultrafiltration with dialysis.
A fair bit of caution should be exercised before ordering and/or interpreting brain natriuretic peptide levels in patients with advanced CKD or those treated with dialysis.
