The Value of Serum Levels of Apela and Cystatin C in Evaluation of Renal Insufficiency in Patients with Heart Failure

Abstract

Objective: To explore the value of serum levels of Apela and Cystatin C (Cys-C) in evaluation of renal insufficiency in patients with heart failure (HF). Methods: Total 89 patients were divided into HF with normal renal function group (HF group, 20 cases); HF with renal insufficiency (RI) in compensatory stage group (HF with compensatory RI group, 40 cases); HF with RI in decompensatory stage group (HF with decompensatory RI group, 29 cases). The serum concentration of Apela, Cys-C and nitrogen-terminal pro-brain natriuretic peptide (NT-pro BNP) was detected by ELISA, and left ventricular ejection fraction (LVEF) was determined by echocardiography. Results: The LVEF level was significantly lower (43.1% ± 1.7% vs. 48.9% ± 2.0%, P < 0.05), but the average level of NT-pro BNP (6174 ± 1002 pg/ml vs. 3400 ± 661.3 pg/ml, P < 0.05) was remarkably higher in HF with decompensatory RI group than that in HF group. With the deterioration of renal function in patients with heart failure, the levels of BUN, Cr and Cys-C increased gradually, while the levels of eGFR decreased gradually. Compared to HF group (0.84 ± 0.55 ng/ml), the serum level of Apela was higher in patients with compensatory (1.16 ± 0.34 ng/ml) or decompensatory RI (1.23 ± 0.53 ng/ml). The serum Cys-C level was negatively correlated with eGFR (r = −0.7763, p < 0.0001). Conclusion: With the occurrence of RI in HF patients, serum Apela and Cys-C increased gradually, and the level of serum Cys-C was well correlated with eGFR. It suggested that endogenous Apela and Cys-C levels could be used as biomarkers for evaluating early RI in patients with heart failure.