Wettersten N, Horiuchi Y, van Veldhuisen DJ, et al. - Researchers undertook this prospective, international, multicentre study, named the Acute Kidney Injury NGAL Evaluation of Symptomatic heart faIlure Study (AKINESIS), to examine the link between worsening renal function (WRF) and a reduction in B-type natriuretic peptide (BNP) with in-hospital and 1-year mortality in acute heart failure. A sustained rise of ≥ 44.2 μmol/L (0.5 mg/dL) or ≥ 50% in creatinine defined severe WRF (sWRF), and a non-sustained rise of ≥ 26.5 μmol/L (0.3 mg/dL) or ≥ 50% in creatinine defined non-severe WRF (nsWRF), and WRF with clinical deterioration was nsWRF with renal replacement therapy, inotrope use, or mechanical ventilation. They noted that there was no difference in the incidence of WRF between patients with or without reduced BNP in a sample of 814 patients. A significant link with 1-year mortality was shown by reduced BNP, sWRF, and WRF with clinical deterioration, as revealed in multivariate Cox regression analysis. Findings revealed better in-hospital and long-term outcomes in relation to reduced BNP. In patients without reduced BNP, WRF was only related to adverse consequences.