Hypoxia-inducible factor 1 (HIF-1) as a biomarker of acute kidney injury in patients with acute decompensation of chronic heart failure

Abstract

Actuality. Impaired kidney function adversely influences both immediate and remote prognosis for patients with chronic heart failure (CHF). However, early detection and prediction of acute kidney injury (AKI) are understudied.The aim of study was to investigate hypoxia-inducible factor 1 (HIF-1) as a biomarker for early diagnosis of AKI and determining prognosis in patients with acute decompensated CHF (ADCHF).

Materials and methods: 84 patients admitted for ADCHF (18 women; mean age, 61.4±7.1) were evaluated. ADCHF was diagnosed in accordance with SEHF guidelines for diagnosis and treatment of chronic heart failure (RCS, 2016). AKI was diagnosed according to KDIGO criteria (2012). HIF-1, N-terminal pro B-type natriuretic peptide (NТ-proBNP), and erythropoietin were measured in blood serum. The follow-up period lasted for 12 months.

Results: AKI was diagnosed in 27 (32.1 %) patients. Level of HIF-1 was 1.27±0.63 ng / ml; NТ-proBNP - 2469.6 (interquartile range (IQR), 1312.2; 3300.0) pg / ml; eryhthropoietin - 56.0 mIU / ml (IQR, 13.2; 68.1). No correlation was found between HIF-1 and glomerular filtration rate, NТ-proBNP, or erythropoietin. Differences in biomarker levels were not observed between patients with and without AKI; however, HIF-1 was higher in the group of deceased patients than in the group of survived patients (1.64±0.9 vs. 1.17±0.44 ng / ml, р=0.004), which was not observed for NТ-proBNP and erythropoietin.

Conclusion: AKI was observed in every third patient with ADCHF. In ADCHF, HIF-1 was not correlated with the kidney function; however, a relationship was found between the HIF-1 level and prediction for patients with CHF.