Abstract | OBJECTIVE: MATERIALS AND METHODS: In this study, we used a cohort design and carried it out in two phases over a period of 30 months (August 2011-February 2014). Thirty-one patients with hyponatremia were recruited into the study. In Phase1, 10 patients were diagnosed to have either SIADH or CSW based on their central venous pressure (CVP). In all of them, blood for NT-proBNP was collected prior to starting treatment. At a later stage, the NT-proBNP results were compared with central venous pressure (CVP) and the clinical diagnosis. Patients diagnosed to have SIADH (CVP >5cm) had NT-proBNP levels <125pg/ml and those with a diagnosis of CSW (CVP <5cm) had NT-proBNP levels >125pg/ml. In Phase2, 21 patients were categorized and treated according to their NT-proBNP levels. Those with NT-proBNP levels <125 pg/ml were treated as SIADH, and those with NT-proBNP levels >125 pg/ml were treated as CSW. RESULTS: In Phase 1, NT-proBNP could detect hypovolemia in patients with CSW with 100% sensitivity and 66.7% specificity (P < 0.07). In Phase 2, NT-proBNP could detect hypovolemia in patients with CSW with 90% sensitivity and 100% specificity (P < 0.001). Combining the results of Phase 1 and Phase 2, NT-proBNP could diagnose CSW with 87.50% sensitivity and 93.33% specificity (P < 0.001). The positive predictive value was 93.33% and the negative predictive value was 87.50%. CONCLUSION: NT Pro-BNP is a quick and convenient assay to differentiate SIADH and CSW. We need a larger sample size to correctly characterize the cut off value. Uric acid cannot be used to distinguish between SIADH and CSW.
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Authors | George Tobin, Ari G Chacko, Rajaratnam Simon |
Journal | Neurology India
(Neurol India)
2018 Sep-Oct
Vol. 66
Issue 5
Pg. 1383-1388
ISSN: 0028-3886 [Print] India |
PMID | 30233009
(Publication Type: Journal Article)
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Chemical References |
- Biomarkers
- Peptide Fragments
- pro-brain natriuretic peptide (1-76)
- Natriuretic Peptide, Brain
- Uric Acid
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Topics |
- Adult
- Aged
- Biomarkers
(blood)
- Female
- Humans
- Hyponatremia
(blood, complications)
- Hypovolemia
(blood, diagnosis, etiology)
- Male
- Middle Aged
- Natriuresis
(physiology)
- Natriuretic Peptide, Brain
(blood)
- Peptide Fragments
(blood)
- Sensitivity and Specificity
- Uric Acid
(blood)
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