Serum N-terminal pro-B-type natriuretic peptide and physical performance in middle-aged and older patients with chronic kidney disease.

BACKGROUND: Observational studies have reported that impaired physical performance is associated with an elevated risk for cardiovascular disease (CVD) in patients with non-dialysis chronic kidney disease (CKD). However, there is limited evidence supporting this finding from a pathological perspective. As such, the present study aimed to determine the association between physical performance variables and serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, a biomarker for estimating CVD risk, in patients with non-dialysis CKD. METHODS: This cross-sectional study involved 113 middle-aged and older patients with CKD (mean [ ± SD] age, 66 ± 9 years; 50.4% women). We evaluated serum NT-proBNP levels, handgrip strength, knee extension strength, 30-second chair stand test, maximal gait speed, 60-second single-leg stance test, and sit-and-reach tests. RESULTS: Decreased handgrip strength, knee extension strength, and 60-second single-leg stance score were associated with elevated serum NT-proBNP levels after adjusting for age, sex, hypertension, diabetes, dyslipidemia, body mass index, urinary albumin-to-creatinine ratio, estimated glomerular filtration rate, medication use (ie, diuretic use, β-blocker use, renin-angiotensin system inhibitor use), and physical activity level (all P < .05). Moreover, stepwise regression analysis revealed that the score for completion of the 60-second single-leg stance test was selected as a covariate of serum NT-proBNP levels, even after adjusting for muscle strength variable. CONCLUSIONS: Results of this study suggest that attenuated muscle strength and balance function tend to be associated with higher serum NT-proBNP levels in patients with non-dialysis CKD, which expands previous observational findings.