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

Koen W. Streng, Hans L. Hillege, Jozine M. ter Maaten, Dirk J. van Veldhuisen, Kenneth Dickstein, Nilesh J. Samani, Leong L. Ng, Marco Metra, Gerasimos S. Filippatos, Piotr Ponikowski, Faiez Zannad, Stefan D. Anker, Peter van der Meer, Chim C. Lang, Adriaan A. Voors (Lead / Corresponding author), Kevin Damman

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)
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Background: Recent 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.

Methods: In 2070, in chronic heart failure patients, we measured several established and upcoming urinary markers reflecting different nephron segments.

Results: Mean 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 m2, 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] μg/gCr, P < 0.001) and KIM-1 (2.28 [1.49-4.37] versus 1.79 [0.85-3.49] μg/gCr, P = 0.001). These differences were more pronounced in patients with an eGFR > 60 ml/min/1.73m2.

Conclusions: HFpEF patients showed more evidence of tubular damage and/or dysfunction compared with HFrEF patients, in particular when glomerular function was preserved.

Original languageEnglish
Pages (from-to)3-12
Number of pages10
JournalJournal of cardiovascular translational research
Early online date16 Feb 2023
Publication statusPublished - Feb 2024


  • Heart failure
  • Renal function
  • Urinary markers
  • Proximal tubule


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