P2467Markers of acute kidney injury in patients with acute decompensated heart failure in the assessment methods decongestion

Abstract

Background: Our purpose was to compare and assess “early” (at day 4–6) and “late” (discharge - Dsc) effects of prolonged optimal-dosed nitrate continuous infusion plus low doses of i.v. diuretics (“nitrate centered strategy” - NC) and moderate doses of i.v. diuretics plus short intermittent nitrate infusion (“diuretic-centered strategy” - DC) on congestion markers (NT-pro-BNP) and renal function (e.g. Cystatin C) and tubular damage (NGAL) biomarkers in pts with acute decompensated heart failure (ADHF).Methods: In single-blind parallel-group study pts with “wet-warm” ADHF were randomized 1:2 into 2 groups. NC group (n=31) received optimal-dosed NTG continuous infusion ≥72 hrs plus low doses of i.v. diuretic (≤80 mg pd for furosemide), while DC group (n=60) moderate doses of i.v. diuretic (41–120 mg pd for furosemide) plus short intermittent (<10hrs pd, ≤3 days) NTG. Congestion endpoints was plasma NT-pro-BNP (ELISA) at D4–6 and Dsc. Renal endpoints included acute kidney injury with AKIN criteria as well as eGRF (MDRD) and serum Cystatin C as functional injury biomarkers and plasma NGAL as tubular damage biomarker, both at D4–6 and Dsc.