Novel Biomarkers of Kidney Disease in Advanced Heart Failure: Beyond GFR and Proteinuria

Curr Heart Fail Rep. 2022 Aug;19(4):223-235. doi: 10.1007/s11897-022-00557-y. Epub 2022 May 28.

Abstract

Purpose: Kidney disease is a common finding in patients with heart failure and can significantly impact treatment decisions and outcomes. Abnormal kidney function is currently determined in clinical practice using filtration markers in the blood to estimate glomerular filtration rate, but the manifestations of kidney disease in the setting of heart failure are much more complex than this. In this manuscript, we review novel biomarkers that may provide a more well-rounded assessment of kidney disease in patients with heart failure.

Recent findings: Galectin-3, ST2, FGF-23, suPAR, miRNA, GDF-15, and NAG may be prognostic of kidney disease progression. L-FABP and suPAR may help predict acute kidney injury (AKI). ST2 and NAG may be helpful in diuretic resistance. Several biomarkers may be useful in determining prognosis of long-term kidney disease progression, prediction of AKI, and development of diuretic resistance. Further research into the mechanisms of kidney disease in heart failure utilizing many of these biomarkers may lead to the identification of therapeutic targets.

Keywords: Biomarkers; Cardiorenal; Heart failure; Kidney disease; Kidney function.

Publication types

  • Review
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Kidney Injury*
  • Biomarkers
  • Disease Progression
  • Diuretics
  • Glomerular Filtration Rate
  • Heart Failure* / diagnosis
  • Humans
  • Interleukin-1 Receptor-Like 1 Protein
  • Proteinuria
  • Receptors, Urokinase Plasminogen Activator

Substances

  • Biomarkers
  • Diuretics
  • Interleukin-1 Receptor-Like 1 Protein
  • Receptors, Urokinase Plasminogen Activator