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1 Department of Cardiology and Endocrinology, Frderiksberg University Hospital, Frederiksberg, 2000, Denmark
2 Department of Anesthesiology, Copenhagen University Hospital, Copenhagen, 2100, Denmark; The Copenhagen Muscle Research Center, Copenhagen University Hospital, Copenhagen, 2100, Denmark
3 Department of Hepatology, Copenhagen University Hospital, Copenhagen, 2100, Denmark
4 Department of Anesthesiology, Copenhagen University Hospital, Copenhagen, 2100, Denmark
5 Department of Cardiology, Copenhagen University Hospital, Copenhagen, 2100, Denmark
* To whom correspondence should be addressed. E-mail: morten.schou{at}fh.hosp.dk.
Renal metabolism of the cardiac marker N-terminal-pro-BNP (NT-proBNP) has been suggested. Therefore, we determined the renal extraction ratios of NT-proBNP and its bioactive co-product brain-natriuretic-peptide (BNP) at rest and during exercise. In addition, the cerebral ratios were evaluated. METHODS: Ten young healthy males were investigated at baseline, during moderate cycle exercise (HR:140, Borg-scale: 14-15) and in the recovery with BNP and NT-proBNP measured from the brachial artery, the jugular and the renal veins, and the renal and cerebral extraction ratios (EXT-Ren and EXT-Cer) were calculated. Cardiac output, stroke volume, heart rate, mean arterial pressures and estimated glomerular filtration were determined. RESULTS: BNP and NT-proBNP were extracted by the kidneys, but not by the brain. We observed no effect of exercise. The mean values (+/-SEM) of EXT-Ren of NT-proBNP were similar (0.19+/-0.05, 0.21+/-0.06 and 0.12+/-0.03, respectively) during the three sessions (P>0.05). Also the EXT-Ren of BNP were similar (0.18+/-0.07, 0.15+/-0.11 and 0.14+/-0.06, respectively (P>0.05)). There were no significant differences between EXT-Ren of BNP and NT-proBNP during the three sessions (P>0.05). EXT-Cer of both peptides varied insignificantly between -0.21+/-0.15 and 0.11+/-0.08. CONCLUSIONS: Both the renal extraction ratio of BNP and NT-proBNP is approximately 0.15-0.20. There is no cerebral extraction and short-term moderate exercise does not affect these values. Our findings suggest that the kidneys extract BNP and NT-proBNP to a similar extent in healthy young males.
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