Objective To investigate the relationship between abnormal expression of serum endog-enous Apelin precursor peptide,Apela and sST2 and renal failure in elderly patients with CHF,and explore the predictive value of the two marker in predicting renal function deterioration.Methods A total of 210 elderly CHF patients admitted to our department from April 2022 to April 2024 were recruited,and divided into renal failure group(71 cases)and non-renal failure group(139 cases)according to having renal failure or not.Another 100 volunteers who taking out-patient health examination in our hospital during the same period were enrolled as the healthy control group.The expression levels of sST2 and endogenous Apela in the peripheral blood sam-ples of all subjects were detected by immunofluorescence assay and ELISA.The renal function indicators were measured with automatic biochemical analyzer.Pearson correlation analysis was used to analyze the correlation between endogenous Apela and sST2 expression and renal func-tion.ROC curves were plotted to evaluate the predictive value and AUC value of endogenous Apela and sST2 for renal failure in elderly CHF patients.Results The renal failure group had sig-nificantly higher expression levels of endogenous Apela and sST2,and elevated levels of 24-hour urine protein,creatinine and blood urea nitrogen than the non-renal failure group and healthy con-trol group(P＜0.05),and the expression levels of endogenous Apela and sST2 in peripheral blood samples were obviously higher in the non-renal failure group than the healthy control group(P＜0.05).Pearson correlation analysis showed that the expression levels of endogenous Apela and sST2 in the peripheral blood of elderly patients with CHF and renal failure was positively correla-ted with 24-hour urine protein,creatinine and blood urea nitrogen(r=0.346,r=0.752,r=0.565,P＜0.01;r=0.357,r=0.687,r=0.501,P＜0.01).The AUC value of sST2 in diagnosing renal failure in elderly CHF patients was 0.765(95％CI:0.658-0.874),with a sensitivity of 76.1％and a specificity of 79.9％,and the AUC value of endogenous Apela was 0.686(95％CI:0.563-0.809),with a sensitivity of 64.8％and a specificity of 68.3％.When the two markers combined together,the AUC value was 0.818(95％CI:0.712-0.919),the sensitivity was 88.7％,and the specificity was 69.1％.Conclusion High expression of endogenous Apela and sST2 in peripheral blood is closely associated with renal failure in elderly CHF patients,and the two markers have important value in predicting the severity of renal failure in elderly CHF patients.
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