Biomonitoring and Cardiorenal Syndrome in Heart Failure(BIONICS-HF) Trial

• the initiation of renal replacement therapy [ Time Frame: From beginning of hospitalization to a follow up of 60 days ] [ Designated as safety issue: No ]
• all cause mortality [ Time Frame: From beginning of hospitalization to a follow up of 60 days ] [ Designated as safety issue: No ]

The purpose of this study is to evaluate the ability of a non-invasive monitor that measures how much fluid is in the body as well as various blood tests for their ability to predict worsening kidney function in patients with heart failure.

Our specific aims are to:

1. Evaluate the individual and collective ability of pro-B type natriuretic peptide (NT-pro-BNP), soluble (s)ST2, neutrophil gelatinase-associated lipocalin (NGAL), and bioelectrical impedance vector analysis (BIVA) for predicting in-hospital worsening renal function (WRF) in patients evaluated in emergency department (ED)with acutely decompensated heart failure (ADHF)compared to a model of clinical variables alone.
2. Evaluate the individual and collective ability of NT-proBNP, sST2, NGAL, and BIVA for identifying the correct cause of in-hospital WRF in patients evaluated in the ED with ADHF.
3. Evaluate the individual and collective ability of NT-pro-BNP, sST2, NGAL, and BIVA for predicting outcomes (all-cause death, all-cause re-hospitalization, initiation of renal replacement therapy by 180 days) in patients with ADHF.

Patients presenting to the Emergency Department of the Massachusetts General Hospital with complaints compatible with Acute Decompensated Heart Failure (ADHF)

• Cardiorenal Syndrome
• Acute Decompensated Heart Failure

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Inclusion Criteria:

• Dyspnea thought to be due to ADHF
• NYHA class III or IV symptoms

Exclusion Criteria:

• renal failure requiring renal replacement therapy rior to enrollment
• unable or unwilling to participate
• > 6 hours from first dose of intravenous diuretic