Conclusions
BNP and NT-proBNP offer important diagnostic and prognostic information in AHF. Consideration of common background factors including age, preservation or reduction of LVEF, age, obesity and renal function will occasionally be required to help clinicians interpret B peptide concentrations in breathless patients. However, in ADHF the typical acute elevation of plasma B peptide is so profound that good discrimination is maintained in the vast majority of cases. In contrast to the relatively mature state of markers for ADHF, we are currently bereft of reliable high-performing markers of AKI with NGAL, KIM1 and other candidates so far failing to meet the performance required to aid clinical practice. IGFBP7 and TIMP-2 have shown promise as markers of AKI in a heterogenous intensive care population but are yet to be evaluated fully in ADHF.