Gökhan Ceyhun1, Mustafa Öztürk2, Zafer Küçüksu3, Sidar Şiyar Aydın1, Mustafa Özkoç1, Onur Altınkaya1, Azman Ateş4

1Department of Cardiology, Medical Faculty, Atatürk University, Erzincan, Turkey
2Department of Cardiology, University of Health Sciences, Erzurum Education and Research Hospital, Erzincan, Turkey
3Department of Cardiology, Erzincan University Mengucek Gazi Research and Training Hospital, Erzincan, Turkey
4Department of Cardiovascular Surgery, Medical Faculty, Atatürk University, Erzincan, Turkey

Keywords: B-type natriuretic peptide/ferritin ratio, heart failure, renal injury


OBJECTIVES: Acute decompensated heart failure (ADHF) is a clinical condition that requires urgent diagnosis and treatment. Patients present with pulmonary capillary wedge pressure, pulmonary arterial pressure, and venous pressure elevation. Along with the progressive deterioration observed in the clinical picture, impairment or deterioration of kidney function may also occur. In this study, we evaluated the B-type natriuretic peptide (BNP)/ferritin ratio as a predictor of the risk of developing acute renal injury (ARI) in ADHF.

METHODS: A total of 157 patients with a diagnosis of ischemic dilated cardiomyopathy for more than 6 months that presented to our clinic with ADHF were included in this cohort study. After the treatment protocol was applied, the sample was divided into two groups as patients with and without ARI. The BNP and ferritin levels were examined along with the routine blood parameters (BNP), and the BNP, ferritin, and BNP/ferritin values were compared between the groups.

RESULTS: ARI was present in 34.3% (n = 54) of the patients, who were also found to have higher BNP (892.76 vs. 817.54), lower ferritin (86.78 ± 57.2 vs. 105.46 ± 38.3), and higher BNP/ferritin (10.48 ± 2.14 vs. 7.89 ± 1.89). The multivariate logistic regression analysis revealed the BNP/ferritin ratio as an independent risk factor for ARI (odds ratio = 3.19; 95% CI, 1.92-6.54; P = 0.001). Using the receiver operating characteristic curve, a cutoff value of 9.32 for BNP/ferritin ratio had a sensitivity of 81.8% and a specificity of 93.5% (area under the curve 0.842, P < 0.001) for the prediction of ARI.

CONCLUSION: The BNP/ferritin ratio is a new parameter that can be used to draw attention to the severity of the treatment and renal function in ADHF cases in emergency situations.

Ethics Committee Approval

Institutional review board approval was obtained from the Atatürk University Board of Ethics on Clinical Studies Ethics Committee (Date: June 26, 2020, Number: 07/25).

Author Contributions

Küçüksu Z. and Öztürk M. performed the measurements, Ceyhun G. and Aydın Ş.S. were involved in planning and supervised the work, Ceyhun G. processed the experimental data, performed the analysis, drafted the manuscript and designed the figures. Özkoç M., Altınkaya O., Ateş A., aided in interpreting the results and worked on the manuscript. All authors provided critical feedback and helped shape the research, analysis and manuscript.

Conflict of Interest

None Declared.

Financial Disclosure