EVALUATION OF NEPRILYSIN, OSTEOPROTEGERIN AND HEART FATTY ACID-BINDING PROTEIN AS PREDICTIVE BIOMARKERS FOR HEART FAILURE IN PATIENTS WITH END STAGE KIDNEY DISEASE UNDERGOING REGULAR HEMODIALYSIS

Abstract

Background:Chronic kidney disease (CKD) is a serious disorder that gradually deteriorates all kidney functions over time. Numerous studies and research have demonstrated that patients with advanced stages of chronic kidney disease are more vulnerable to cardiovascular and arterial diseases, particularly heart failure. It is important to find reliable biomarkers like osteoprotegerin (OPG), neprilysin (NEP), and heart fatty acid binding protein (HFABP) that can predict HF risk in these people so that it can be found early and treated.

Methodology:We conducted a case-control study with a total of 130 participants between May 24, 2023, and October 20, 2023. We obtained all samples from two hospitals located in central Baghdad, Iraq. The age range of patients included in the study was 18 to 75 years. Participants and dialysis patients were classified based on whether or not they had heart failure. Group 1 consisted of 70 individuals without heart disease, whereas Group 2 consisted of 40 patients with heart failure.

Results:The study compared mean NEP, OPG, HFABP, cholesterol, triglyceride, VLDL, and LDL levels between two groups: HD patients with normal heart failure (HD-NHF) and HD patients with heart failure (HD-HF), and the results were all significantly higher in the HD-HF group compared to HD-NHF with a P-value, respectively (<0,001,< 0,001,< 0,001,< 0,001, 0.01, 0.01, and < 0.001). The results show NEP, OPG, and HFABP were over double the value, and LDL was more than 40% higher in the HD-HF group. All observed discrepancies exhibited a high level of statistical significance, as indicated by p-values that were considerably lower than 0.01.

Logistic regression found OPG to be the strongest predictor of HD-HF versus HD-NHF, followed by NEP with an odds ratio of 1.01 and 8.71, respectively. HFABP was also significantly predicted, with an odds ratio of 1.09.

Conclusion:The study focuses on potential biomarkers for the prediction and diagnosis of heart failure in hemodialysis patients. All biomarkers (OPG, NEP, and HFABP) and their relationship with other biomarkers, which are very important in predicting heart failure, were examined. In this group of patents, OPG and NEP, in particular, have shown strong predictive value for heart failure. These findings could help develop better diagnosis and management for heart failure in patients undergoing dialysis.