NPPB and heart failure: In light of these challenges, the discovery of valid, noninvasive biomarkers to forecast cardiovascular events in CKD is a high-priority clinical need.7 Of these most promising of markers, BNP and NT-proBNP are two which are released by the cardiac ventricles when there is myocardial wall stress and volume overload.8 BNP is active biologically and has been a popular mode of diagnosis of cardiac failure.