Correlation between urinary and serum NT‐proBNP in acute bronchiolitis: A pilot study

• Published in: Pediatric pulmonology Vol. 58; no. 2; pp. 492 - 499
• Main Authors: Rodríguez‐González, Moises, Castellano‐Martínez, Ana, Estalella‐Mendoza, Ana, Rodríguez‐Campoy, Patricia, Estepa‐Pedregosa, Lorena, Calero‐Ruiz, María Mercedes, Sáez‐Benito Godino, Ana, Flores‐González, Jose Carlos
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01-02-2023
• Subjects: acute bronchiolitis; Biomarkers; Bronchiolitis; Humans; Infant; infections: pneumonia; myocardial strain; Natriuretic Peptide, Brain; natriuretic peptides; Peptide Fragments; Peptides; Pilot Projects; pulmonary hypertension; Respiratory diseases; urinary NT‐proBNP; Urine; viral; natriuretic peptides; urinary NT-proBNP; biomarkers; pulmonary hypertension; myocardial strain; viral; acute bronchiolitis; infections: pneumonia; TB
• ISSN: 8755-6863; 1099-0496
• DOI: 10.1002/ppul.26215

Background and Aims
We aimed to analyze the correlation of urinary with serum N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) concentrations and its association with severity in acute bronchiolitis.
Material and Methods
A pilot observational study was conducted between October 1, 2021 and March 31, 2022 including acute bronchiolitis cases who attended our institution. Serum and urinary NT‐proBNP concentrations were determined using the Alere i NT‐proBNP assay in time‐matched urine and blood samples. The Mann−Whitney U test, Spearman's correlations, and simple linear regression were utilized to analyze the association of urine NT‐proBNP levels with serum NT‐proBNP and with variables indicative of severe bronchiolitis.
Results
Seventeen infants (median age 68 [IQR: 36−91] days) with 36 time‐matched samples were included. The urine NT‐proBNP was positively and strongly correlated with the serum NT‐proBNP concentrations (Spearman's ρ = 0.81 & R2 coefficient = 0.751; p < 0.001), and increased with higher C‐reactive protein, (p = 0.004), procalcitonin (p = 0.001), and pCO2 (p = 0.029) levels. The initial urinary NT‐proBNP concentrations were higher in those infants that required ventilatory support compared with those without this outcome (1.85 [IQR: 1.16−2.44] vs. 0.63 [IQR: 0.45−0.84] pg/mg); p < 0.001); and resulted positively and strongly correlated with the duration of the ventilatory support (Spearman's ρ = 0.76; p < 0.001) and the length of stay hospitalization (Spearman's ρ = 0.84; p < 0.001).
Conclusion
The urinary NT‐proBNP concentrations could be a reliable surrogate for serum NT‐proBNP levels and resulted elevated in cases of acute bronchiolitis with complicated evolution, suggesting a potential as a noninvasive tool to assess severity in this setting.