Shirakabe A, et al. - In this analysis of 281 patients with acute heart failure (AHF), researchers wanted to find biomarkers that could predict true worsening renal failure (WRF) in these patients. Within 30 minutes of admission, biomarkers of these patients were measured. Based on the criteria of both acute kidney injury on admission and increasing serum creatinine value during the first 7 days, three groups of patients were defined: non-WRF (n = 168), pseudo-WRF (n = 56), or true-WRF (n = 57) groups. In multivariate Cox regression model, 1,000 day mortality and heart failure events were independently predicted by true WRF. The true-WRF group vs the non-WRF and pseudo-WRF groups demonstrated remarkably higher serum heart-type fatty acid-binding protein (s-HFABP) levels. Overall, for the prediction of the development of true WRF in AHF patients, cardiac biomarkers, particularly s-HFABP, might be useful, with higher predictive ability observed in AHF patients without chronic kidney disease (CKD) vs in those with CKD.