BNP/Creatinine Ratio Index: Explanation and Clinical Context The BNP/Creatinine Ratio is a biomarker-based index used in patients with heart failure and renal dysfunction to assess cardiovascular risk more precisely. Elevated BNP reflects cardiac stress, whereas serum creatinine indicates renal function. Combining these parameters accounts for the confounding effect of renal impairment on BNP levels, enhancing prognostic accuracy.
The ratio is calculated by dividing BNP (pg/mL) by serum creatinine (mg/dL). Higher ratios typically indicate a greater likelihood of adverse cardiac events and may guide risk stratification and treatment decisions.
Normal reference ranges for BNP vary by age, sex, and laboratory standards; interpretation should consider clinical context. This index is particularly useful in patients with chronic kidney disease, where BNP alone may overestimate cardiac stress.
Reference:
Maisel AS, et al. "Utility of B-type natriuretic peptide in patients with renal dysfunction: BNP/Creatinine Ratio." J Am Coll Cardiol. 2004;44:1725-1732. doi:10.1016/j.jacc.2004.07.038