Background. Cardiovascular diseases are the leading course of morbidity/mortality in children with chronic
kidney disease. Recently it has been shown that a brain natriuretic peptide is a sensitive cardiac marker for
classification of the cardiovascular risk in adults. Whether it has the same diagnostic value in children with
chronic kidney diseases has to be established. The purpose of the study was to evaluate whether the brain
natriuretic peptide can predict cardiac dysfunction in children with chronic kidney disease.
Methods and Results. Relation between serum level of the brain natriuretic peptide, echocardiography
and cardiovascular risk factors (hypertension, anaemia, lipids, C-reactive protein, secondary
hyperparathyreoidism) has been studied in 46 children (10 patients at predialysis, 14 patients on dialysis,
11 children with kidney transplant and 11 healthy controls). Brain natriuretic peptide was significantly
higher in dialysed patients (2.09 ± 0.78) in comparison with healthy children (1.43 ± 0.34, p = 0.012)
and with both groups of patients at pre-dialysis stage (1.52 ± 0.42, p = 0.039) and after kidney transplant
(1.71 ± 0.46, p = 0.19). Abnormal heart geometry was found in 19 patients (54.28%). Compared to
controls, brain natriuretic peptide was higher in children with eccentric but not in those with concentric
hypertrophy (2.178 ± 0.956 vs. 1.496 ± 0.395, p = 0.05, resp. 1.982 ± 0.618 vs. 1.496 ± 0.395, p = 0.04).
Significant correlation was found between levels of brain natriuretic peptide and ventricular hypertrophy
(p = 0.00l), with the level of parathyroid hormone (p = 0.03) and with the degree of anaemia (p = 0.027).
Conclusions. Brain natriuretic protein can predict an abnormal geometry of heart in children with
chronic kidney disease. Our preliminary results suggest that it is a suitable marker of cardiovascular
classification in paediatrics.
brain natriuretic peptide, chronic kidney disease, left ventricular hypertrophy, cardiac