November 8, 2012

Kidney woes during heart failure

Levels of the protein NGAL may be a good predictor of worsening kidney function in patients with acute heart failure.

Patients who present to the Emergency Department (ED) with acute heart failure have multiple co-morbidities, including abnormal kidney function, which is associated with increased risk of complications. Reliable early markers of worsening renal function in patients with acute heart failure are lacking.


Sean Collins, M.D., associate professor of Emergency Medicine, and colleagues tested urinary levels of NGAL (an indicator of kidney tubular injury) at presentation and 12-24 hours after treatment in ED patients with acute heart failure. They followed the patients for 5- and 30-day adverse cardiovascular events. The researchers found that high urinary NGAL levels 12-24 hours after ED therapy are associated with both worsening renal function at 72-96 hours and with 30-day adverse events.

The findings, reported in the September issue of the European Journal of Heart Failure, suggest that urinary NGAL levels 12-24 hours after acute heart failure therapy may be a better predictor of worsening renal function than other available laboratory data. If future studies confirm the findings, NGAL may have a role for guiding therapeutic decisions.

This research was supported by grants from the National Heart, Lung and Blood Institute (HL085387) and the National Center for Research Resources/National Center for Advancing Translational Sciences (RR026314) of the National Institutes of Health, and by Abbott Point of Care.