NT-proBNP - A Potential Biomarker of Pulmonary Hypertension

Pulmonary arterial hypertension (PAH), also known as World Health Organization (WHO) Group 1 pulmonary hypertension, is a rare and worsening condition (1). It is a disease characterized by increased blood pressure in the arteries of the lungs, which can lead to heart failure if left untreated.

It involves damage to the lining of the blood vessels in the lungs and changes in the vessel structure. These changes cause increased pressure in the pulmonary arteries, higher resistance in the blood vessels, and eventually lead to failure of the right side of the heart (2).

NPPB (Natriuretic Peptide Precursor B) is the gene that encodes the precursor protein for B-type natriuretic peptide (BNP). It is an early-response gene that is activated in cardiac myocytes, particularly in the ventricles, in response to mechanical stress, volume overload, or hormonal and sympathetic stimuli (3). When NPPB is transcribed and translated, it produces a 134-amino acid preproBNP, which undergoes further processing to generate BNP and NT-proBNP, both important biomarkers used in diagnosing and managing heart failure and other cardiovascular conditions (2). NT-proBNP has no known biological function but, due to its longer half-life compared to BNP (70 minutes versus 22 minutes) (4) and greater stability during storage (5), it offers potential advantages for use as a biomarker in clinical settings (4, 5).

NT-proBNP – A Potential Biomarker of Pulmonary Hypertension

A recent study explored the pathophysiological changes in patients during hemodialysis and blood reinfusion in patients with kidney disease.

The NT-proBNP ELISA from BIOMEDICA was used to measure NT-proBNP plasma levels for the noninvasive estimation of pulmonary arterial pressure (PAP) patients with chronic kidney failure:

Pathophysiological changes in patients during hemodialysis and blood reinfusion predict potential development of hemodialysis reactions. Pethő ÁG et al., Ren Fail. 2025.

Abstract

Hemodialysis reactions (HDRs) are a type of hypersensitivity reactions (HSRs), such as complement activation-related pseudoallergy (CARPA) observed during nanoparticle infusions. Our study aimed to elucidate the mechanisms of human HDRs by focusing on hemodynamic and clinical chemistry changes of HSR-related or biocompatibility issues during human hemodialysis (HD) and the reinfusion of blood. Based on our recent animal experiments, we hypothesize that increased pulmonary arterial pressure (PAP), and increases in thromboxane B2 (TXB2) and complement 3a (C3a) plasma concentrations will likely manifest in, or at least predict, human HDRs during HD and blood reinfusion. To verify our hypothesis, we measured these parameters during high-flux HD in patients. Since direct PAP measurement was not possible, the plasma concentration of the N-terminal fragment of the brain natriuretic peptide (NT-proBNP) was determined for the noninvasive estimation of PAP. Our results show an increase in NT-proBNP and TXB2 during the reinfusion of extracorporeal blood. The plasma concentration of C3a increased in early HD already and remained elevated up to blood reinfusion. In conclusion, the observed changes in HSR-related parameters or biocompatibility issues in otherwise asymptomatic patients may suggest that a greater activation of these mechanisms could explain the development of human hemodialysis reactions.

NT-proBNP ELISA | SK-1204 – HIGHLIGHTS

• Convenient – ready -to-use reagents
• Flexible – can be run in every lab
• Two controls included
• TRUSTED – widely cited in over 140 publications
• REPRODICIBLE – rigorously validated following international quality guidelines
• Assay independently validated in saliva samples link

 

DISCOVER MORE:  Protocol Booklet, Validation data file

 

Literature

1. Rare but serious: pulmonary vascular disease around the world. Hjalmarsson C, Jose A, Poor H, Loureiro CMC, Stosor V, Pulido T, Krishnan M. JHLT Open. 2025 Jul 18;9:100327. doi: 10.1016/j.jhlto.2025.100327. PMID: 40808822; PMCID: PMC12345328.
2. BNP/NT-proBNP in pulmonary arterial hypertension: time for point-of-care testing? Lewis RA, Durrington C, Condliffe R, Kiely DG. Eur Respir Rev. 2020 May 15;29(156):200009. doi: 10.1183/16000617.0009-2020. PMID: 32414745; PMCID: PMC9488846
3. Biochemistry of the human B-type natriuretic peptide precursor and molecular aspects of its processing. Semenov AG, Seferian KR. Clin Chim Acta. 2011 May 12;412(11-12):850-60. doi: 10.1016/j.cca.2011.03.006. Epub 2011 Mar 21. PMID: 21396929.
4. Synthesis, secretion, function, metabolism and application of natriuretic peptides in heart failure. Fu S, Ping P, Wang F, Luo L. J Biol Eng. 2018 Jan 12;12:2. doi: 10.1186/s13036-017-0093-0. PMID: 29344085; PMCID: PMC5766980.
5. Amino-terminal pro-B-type natriuretic peptide: analytic considerations. Ordonez-Llanos J, Collinson PO, Christenson RH. Am J Cardiol. 2008 Feb 4;101(3A):9-15. doi: 10.1016/j.amjcard.2007.11.013. PMID: 18243867.
6. Pathophysiological changes in patients during hemodialysis and blood reinfusion predict potential development of hemodialysis reactions. Pethő ÁG, Révész C, Mészáros T, Sáfár O, Rosivall L, Domán J, Szénási G, Gigacz T, Dézsi L. Ren Fail. 2025 Dec;47(1):2500662. doi: 10.1080/0886022X.2025.2500662. Epub 2025 May 6. PMID: 40328739; PMCID: PMC12057777.

 

Further reading

• NT-proBNP Levels in Hemodialysis Patients: Unrelated to Interdialytic Weight Gain, Limited in Detecting Left Ventricular Systolic Dysfunction, but May Identify Atrial Fibrillation. Divani M, Katsanaki K, Tziastoudi M, Makri P, Poulianiti C, Lykotsetas E, Balatsouka A, Stefanidis I, Eleftheriadis Kidney and Dialysis. 2026; 6(2):42.  
• Dialysis for Chronic Kidney Failure: A Review. Flythe JE, Watnick S. JAMA. 2024 Nov 12;332(18):1559-1573. doi: 10.1001/jama.2024.16338. PMID: 39356511.