Prognostic value of hepatocyte growth factor in dialysis patients with heart failure

Objective The aim of this study was to evaluate hepatocyte growth factor (HGF) as a predictor of short-term mortality in patients with chronic renal failure (CRF) and congestive heart failure (CHF) and study its relation to heart failure severity.Design The work was designed as a prospective case–control study.Patients and methods The study included 52 CRF patients with heart failure: 41 patients were on regular dialysis (group 1) and 11 patients were on conservative treatment (group 2). They were compared with 11 CHF patients with normal renal function (group 3), 10 CRF patients on regular dialysis and normal cardiac function (group 4), and 15 healthy controls (group 5). Initial baseline characteristics, New York Heart Association Classification of Heart Failure, serum HGF, and cardiac functions by echocardiography were determined. All groups were prospectively followed up for 6 months in order to determine mortality.Results The mean HGF level in group 1 (1.3±0.96 ng/ml), group 2 (0.65±0.25 ng/ml), group 3 (1.34±0.61 ng/ml), and group 4 (1.67±0.89 ng/ml) was significantly higher than the level in the control group (0.25±0.24 ng/ml) (P<0.0001). Post-hoc test showed a nonsignificant difference in HGF concentration between group 1 and other groups. Patients with a moderate degree of CHF in group 1 had significantly higher HGF than those with a mild degree (1.7±1 vs. 0.78±0.6 ng/ml) (P=0.002). In group 1, bivariate correlation analysis showed a positive correlation of HGF and left atrium diameter (r=0.34, P=0.03) and a negative correlation with ejection fraction (r=−0.45, P=0.0003). No statistically significant difference was found in HGF levels between patients who survived (1.27±0.94 ng/ml) and those who did not survive (1.26±0.75 ng/ml) in group 1 (P=0.9).Conclusion In this study, serum HGF was found to be a good marker of severity of heart failure in CRF patients undergoing dialysis. However, it was not associated with mortality.