Introduction: Urinary Liver-type Fatty Acid Binding Protein (uL-FABP) is known as a marker reflecting renal tubular impairment in worsening renal function (WRF). However, its clinical significance has not been elucidated in patients with acute decompensated heart failure (ADHF), especially changes of uL-FABP is little known. Methods and Results: This prospective, observational study included 208 patients (mean age: 77 year, 51% male) presenting with ADHF. uL-FABP and other biomarkers were measured at admission and before discharge. WRF was defined as a rise in serum creatinine >0.3 mg/dl within seven days from admission. Median uL-FABP/Cr levels significantly decreased from 7.8 to 2.9 µg/gCr (P < .0001). These changes of uL-FABP were correlated with changes of aspartate aminotransferase (r = 0.27, P < .0001) and alanine aminotransferase (r = 0.24, P < .0001), although they were not correlated with changes of brain natriuretic peptide and estimated glomerular filtration rate. uL-FABP/Cr levels at admission were associated with WRF in the univariate logistic regression analysis (P = .03), but changes of uL-FABP/Cr were not associated. Conclusion: In patients with ADHF, uL-FABP decreased significantly during treatment. The decrease was correlated with changes of liver enzyme, though it was not associated with WRF.
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