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Urinary NT-proBNP and ductal closure in preterm infants

Journal of Perinatology volume 33, pages 212–217 (2013)Cite this article

Subjects

Abstract

Objective:

To explore the association of urinary N-terminal pro-brain natriuretic peptide (NT-proBNP) concentrations and closure of patent ductus arteriosus (PDA) in preterm infants.

Study design:

Blinded prospective study involving 136 preterm infants (median (interquartile range) gestational age 28 (26 to 30) weeks; birth weight 1030 (780 to 1270) g). NT-proBNP was determined in urine collected on day of life (DOL) 2, 7, 14 and 28.

Result:

Urinary NT-proBNP/creatinine ratios declined continuously between DOL 2 (74 (17 to 248) μg g−1) and DOL 28 (4 (2 to 12) μg g−1) and were significantly elevated in ventilated infants on DOL 2, 7 and 14, and in ventilated infants with a hemodynamically significant PDA on DOL 2. Furthermore, urinary NT-proBNP/creatinine ratios on day 14 were higher in 14 ventilated infants who did not respond to pharmacological treatment and subsequently required surgical PDA closure (247 (214 to 547) μg g−1) than in ventilated infants (n=7) with successful pharmacological PDA closure (55 (21 to 114) μg g−1; P<0.05). A cutoff >210 μg g−1 on day 14 had a sensitivity of 75% and specificity of 100% for predicting non-responsiveness to pharmacological treatment.

Conclusion:

Measurement of urinary NT-proBNP is a new and simple non-invasive test for preterm infants, which may be helpful in guiding PDA treatment decisions.

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Acknowledgements

This study was supported by Roche Diagnostics, Mannheim, Germany. The assay manufacturer had no influence on study design, data analysis or interpretation or the content of this manuscript. We thank the Neonatal Intensive Care Unit nurses and doctors for their assistance during the examinations, and Janett Reiche and Fabian Holert of the Research Laboratory for technical support. We are very grateful to Sarah Smithson-Compton, MA for editorial assistance.

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Authors and Affiliations

  1. Department of Neonatology, Klinik für Neonatologie,

    C Czernik, B Metze & C Bührer

  2. Charité University Medical Center, Berlin, Germany

    C Czernik, B Metze & C Bührer

  3. Institute of Laboratory Medicine, Charité University Medical Center, Berlin, Germany

    C Müller

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  1. C Czernik
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  2. B Metze
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Correspondence to C Czernik.

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Czernik, C., Metze, B., Müller, C. et al. Urinary NT-proBNP and ductal closure in preterm infants. J Perinatol 33, 212–217 (2013). https://doi.org/10.1038/jp.2012.86

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