Comparison between admission natriuretic peptides, NGAL and sST2 testing for the prediction of worsening renal function in patients with acutely decompensated heart failure.

Journal Article

In order to predict the occurrence of worsening renal function (WRF) and of WRF plus in-hospital death, 101 emergency department (ED) patients with acute decompensated heart failure (ADHF) were evaluated with testing for amino-terminal pro-B-type natriuretic peptide (NT-proBNP), BNP, sST2, and neutrophil gelatinase associated lipocalin (NGAL).In a prospective international study, biomarkers were collected at the time of admission; the occurrence of subsequent in hospital WRF was evaluated.In total 26% of patients developed WRF. Compared to patients without WRF, those with WRF had a longer in-hospital length of stay (LOS) (mean LOS 13.1±13.4 days vs. 4.8±3.7 days, p<0.001) and higher in-hospital mortality [6/26 (23%) vs. 2/75 (2.6%), p<0.001]. Among the biomarkers assessed, baseline NT-proBNP (4846 vs. 3024 pg/mL; p=0.04), BNP (609 vs. 435 pg/mL; p=0.05) and NGAL (234 vs. 174 pg/mL; p=0.05) were each higher in those who developed WRF. In logistic regression, the combination of elevated natriuretic peptide and NGAL were additively predictive for WRF (ORNT-proBNP+NGAL=2.79; ORBNP+NGAL=3.11; both p<0.04). Rates of WRF were considerably higher in patients with elevation of both classes of biomarker. Comparable results were observed in a separate cohort of 162 patients with ADHF from a different center.In ED patients with ADHF, the combination of NT-proBNP or BNP plus NGAL at presentation may be useful to predict impending WRF (Clinicaltrials.gov NCT#0150153).

Full Text

Duke Authors

Cited Authors

  • De Berardinis, B; Gaggin, HK; Magrini, L; Belcher, A; Zancla, B; Femia, A; Simon, M; Motiwala, S; Bhardwaj, A; Parry, BA; Nagurney, JT; Coudriou, C; Legrand, M; Sadoune, M; Di Somma, S; Januzzi, JL; Global Research on Acute Conditions Team (GREAT),

Published Date

  • March 2015

Published In

Volume / Issue

  • 53 / 4

Start / End Page

  • 613 - 621

PubMed ID

  • 25473804

Electronic International Standard Serial Number (EISSN)

  • 1437-4331

International Standard Serial Number (ISSN)

  • 1434-6621

Digital Object Identifier (DOI)

  • 10.1515/cclm-2014-0191

Language

  • eng