Plasma B-type natriuretic peptide (BNP) in acute Puumala hantavirus infection

Abstract

Background. Nephropathia epidemica (NE) is a haemorrhagic fever with renal syndrome (HFRS) caused by Puumala hantavirus (PUUV). Acute infection causes transient kidney injury, permeability disorder, and fluid retention, for example.Methods. B-type natriuretic peptide (BNP) and N-terminal peptide (NT-proBNP) during NE were investigated; disease severity and development of clinical symptoms were considered.Results. Mean concentrations were 80.2 pg/mL and 55.2 pg/mL for BNP, and 2362.5 pg/mL and 1057.0 pg/mL for NT-proBNP in males and females, respectively. Hospitalization was 6.3 versus 5.2 days (P = 0.01) and 5.9 versus 4.4 days (P = 0.01) for patients with elevated BNP (> 100 pg/mL) or NT-proBNP (> 300 pg/mL), respectively, compared to those with normal peptide concentrations. Weight change during hospitalization was –2.8 or –0.3 kg (P <0.05) in patients with elevated or normal BNP, respectively. Heart rate (r = –0.46, P = 0.001 and r = –0.37, P = 0.01), creatinine clearance (r = –0.46, P = 0.001 and r = –0.56, P = 0.000), blood haemoglobin concentration (r = –0.55, P = 0.000 and r = –0.52, P = 0.000), and C-reactive protein (r = –0.47, P = 0.001 and r = –0.36, P = 0.01) measured when the peptide samples were collected correlated with BNP and NT-proBNP, respectively. In addition, anterior chamber depth of eye and plasma BNP (r = –0.39, P < 0.05) displayed a correlation.Conclusions. BNP and NT-proBNP levels are associated with severity of several clinical features of acute NE.