MUHAMMED EMİR İNCE, SEMAHAT KARAHİSAR ŞİRALİ, MEHMET FATİH BULUCU, AHMET ÇORAKCI
The Journal of European Internal Medicine Professionals - 2025;3(1):6-12
Background: Electrolyte imbalance and volume overload are common in chronic kidney disease and heart failure. We aimed to evaluate the relationship between serum sodium and N terminal pro-brain natriuretic peptide (NT-proBnp) based on estimated glomerular filtration rates in heart failure (HF) patients with low ejection fraction. Methods: A total of 389 patients aged 18-80 years who presented to our hospital with symptoms of heart failure were included in the study. Demographic, laboratory, and echocardiography findings were recorded. The study group consisted of patients with ejection fraction (EF) less than 55% and estimated glomerular filtration rate (eGFR) less than 90mL/min, and subgroups were formed according to eGFR, ejection fraction and NT-proBnp level. Results: Of the total group, 54.5% were female, and the median age was 64 (IQR18) years. Age, NT-ProBnp, creatinine, BUN, and CRP were significantly (p<.05) higher in the study group compared to the control group. When subgroups were compared according to eGFR, age, creatinine, NT-proBnp, BUN, and CRP were significantly (p<.05) higher in the group with eGFR<45mL/min compared to the group with eGFR=45-89mL/min. In the group with NT-proBNP above 6000, it was seen that eGFR, EF, sodium, albumin, and hematocrit were effective at a rate of 38.4% in the multivariate logistic regression model. Conclusion: In HF and low eGFR, NT-proBnp increases with volume increase. In light of the data that NT-proBnp, which is known to be released from stress-induced cardiomyocytes, is excreted and metabolized via the renal route, renal function should be taken into consideration in the interpretation of NT-proBnp elevated levels.
