Urinary Marker Profiles in Heart Failure with Reduced Versus Preserved Ejection Fraction

BackgroundRecent data suggest different causes of renal dysfunction between heart failure with reduced (HFrEF) versus preserved ejection fraction (HFpEF). We therefore studied a wide range of urinary markers reflecting different nephron segments in heart failure patients.MethodsIn 2070, in chronic heart failure patients, we measured several established and upcoming urinary markers reflecting different nephron segments.ResultsMean age was 70 +/- 12 years, 74% was male and 81% (n = 1677) had HFrEF. Mean estimated glomerular filtration rate (eGFR) was lower in patients with HFpEF (56 +/- 23 versus 63 +/- 23 ml/min/1.73 m(2), P = 0.001). Patients with HFpEF had significantly higher values of NGAL (58.1 [24.0-124.8] versus 28.1 [14.6-66.9] mu g/gCr, P < 0.001) and KIM-1 (2.28 [1.49-4.37] versus 1.79 [0.85-3.49] mu g/gCr, P = 0.001). These differences were more pronounced in patients with an eGFR > 60 ml/min/1.73m(2).ConclusionsHFpEF patients showed more evidence of tubular damage and/or dysfunction compared with HFrEF patients, in particular when glomerular function was preserved.