Trial reportCirculation. Heart failure2024
Absence of Kidney Tubular Injury in Patients With Acute Heart Failure With Acute Kidney Injury.
Trial report in Circulation. Heart failure, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01291836 (Acute Kidney Injury Neutrophil Gelatinase-Associated Lipocalin), which is not on this map. Cited by 12 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Acute Kidney Injury Neutrophil Gelatinase-Associated Lipocalin (N-GAL) Evaluation of Symptomatic Heart Failure Study (AKINESIS)
Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Clinical utility of proenkephalin A 119-159 for prediction of worsening renal function and prognosis in patients with sepsis -results of a patient-level meta-analysis.Critical care (London, England) · 2026Pooled it
- Efficacy of ambulatory intravenous diuresis for chronic heart failure patients: Insights from the DEA-HF trial.ESC heart failure · 2025Trial
- The 'Chloride Theory' for Heart Failure Pathophysiology: An Updated Narrative Review 2025.Cardiology and therapy · 2026Review
- Urinary Biomarkers for the Risk Assessment and Management of Heart Failure: Pearls and Pitfalls.Current heart failure reports · 2026Review
- Beyond Creatinine: Novel Renal Biomarkers at the Interface of Kidney Injury and Cardiovascular Risk.Biomedicines · 2026Review
- The creatinine conundrum in heart failure: rethinking AKI definitions.Intensive care medicine · 2026Article
- Renal Recovery Patterns and Long-Term Kidney Function Decline in Pulmonary Hypertension.Pulmonary circulation · 2026Article
- Acute Kidney Injury in Acute Heart Failure Revisited: Marker of Cardiorenal Disease Severity Rather Than Isolated Renal Injury.Life (Basel, Switzerland) · 2026Review
- Managing Heart Failure Therapy in Chronic Kidney Disease: Converging Evidence and Ongoing Controversies.Cardiorenal medicine · 2026Article
- Recent advances in biomarkers for cardiac fibrosis.Frontiers in cardiovascular medicine · 2026Review
- Urine Tubular Biomarkers Are Associated With Natriuresis in Patients With Acute Heart Failure.Journal of the American Heart Association · 2025Article
- Worsening Renal Function in Acute Heart Failure: Not Always Harmful.Current heart failure reports · 2025Review
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundWorsening renal function (WRF) is common in hospitalized patients being treated for acute heart failure. However, discriminating clinically significant WRF remains challenging. In patients hospitalized with acute heart failure, we evaluated if blood and urine biomarkers of cardiac and kidney dysfunction were associated with adverse outcomes.
methodsWe identified 175 of 927 participants in the AKINESIS study (Acute Kidney Neutrophil Gelatinase-Associated Lipocalin Evaluation of Symptomatic Heart Failure Study) who met criteria for stage 1 or 2 Kidney Disease: Improvement Global Outcomes acute kidney injury during the first 3 days of hospitalization. We measured 24 blood and urine biomarkers from specimens collected within 24 hours of meeting acute kidney injury criteria. The primary composite outcome consisted of worsening WRF (higher acute kidney injury stage), need for dialysis, or death at 30 days. Biomarkers' association with the composite outcome was assessed with logistic regression by tertiles and area under the curve (AUC).
resultsOf the 175 participants, 32 (18%) developed the primary composite outcome. Only history of chronic kidney disease was significantly different between those with and without the composite outcome. The highest tertile of plasma Gal-3 (galectin-3) and urine epidermal growth factor were associated with increased odds of the composite outcome compared with the lowest tertile in unadjusted analyses. After adjusting for serum creatinine, systolic blood pressure, and blood urea nitrogen, only the highest tertile of Gal-3 was associated with greater odds of the composite outcome (odds ratio, 4.6 [95% CI, 1.4-16.0). Gal-3 had the highest AUC (0.70 [95% CI, 0.58-0.82]), while epidermal growth factor had a lower AUC (0.63 [95% CI, 0.53-0.74]). Notably, urine biomarkers of kidney tubule injury were not associated with the composite outcome.
conclusionsTubular injury does not occur in most patients with acute heart failure experiencing WRF, consistent with the functional mechanisms of WRF in this patient population. REGISTRATION: URL: https://www.clinicaltrials.gov/study/NCT01291836?term=NCT01291836&rank=1; Unique identifier: NCT01291836.
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