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Why we don't know the answer may be more important than the specific question.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Jaffe, Allan S. Apple, Fred S. Babuin, Luciano |
| Copyright Year | 2004 |
| Abstract | Kemperman et al. (1) have evaluated the relationship of B-type natriuretic peptide (BNP; measured by the Bayer assay) and N-terminal proBNP (NT-proBNP; measured by the Roche assay) in patients treated with a left ventricular assist device (LVAD). They report that the relationship of the results of the two assays changes after prolonged support on a LVAD. Before LVAD use, the ratio of NT-proBNP to BNP is higher than after improvements in hemodynamics with use of the LVAD. They suggest that the initial high ratio reflects impaired renal clearance of NT-proBNP because of abnormal hemodynamics and that the subsequent decrease in the ratio reflects improved renal clearance in response to LVAD support. This may be the case and is one reasonable interpretation of the data given that glomerular filtration was significantly, although modestly, reduced in most patients before use of the LVAD. This hypothesis is consistent with other data suggesting a relationship between BNP and NT-proBNP and renal function (2). However, other explanations are possible, relating to the characteristics of the assays themselves and to physiologic factors in this special group of patients. Many of the issues we will raise ideally should have been explored during the development of the natriuretic assays themselves or during their clinical validation. Thus, there is a need not only to reflect on the specific issues related to BNP and NT-proBNP in patients with impaired renal function but also to ask why, so often, the critical analytical and clinical data that would help answer questions like this are not available in the literature. Initial analytical validation studies tend to be designed to allow an assay to be shown to be useful and/or to pass regulatory muster. There is then some attempt to define a normal reference interval and ultimately an attempt to find a clinical niche … |
| File Format | PDF HTM / HTML |
| DOI | 10.1373/clinchem.2004.037150 |
| Alternate Webpage(s) | http://herian.co.uk/why/we/why_we_don_t_know_the_answer_may_be_more_important_than_specific_question_editorials_clinical_report.pdf |
| Alternate Webpage(s) | http://kadawe.store/why/we/why_we_don_t_know_the_answer_may_be_more_important_than_specific_question_editorials_clinical_report.pdf |
| PubMed reference number | 15331496 |
| Alternate Webpage(s) | https://doi.org/10.1373/clinchem.2004.037150 |
| Journal | Medline |
| Volume Number | 50 |
| Issue Number | 9 |
| Journal | Clinical chemistry |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
