LCN2 and heart failure: Indeed, our study revealed that patients with ACEF scores ≥ 1.1 were older and more likely to have DM, myocardial infarction, PAD, and severe heart failure, which are well-established risk factors for AKI.[7, 8, 23] Another explanation is that patients with ACEF scores < 1.1 have probably received damage to their kidneys (as demonstrated by the similar levels of urinary NGAL to that in patients with ACEF scores ≥ 1.1), but not of sufficient severity to cause any subsequent rise in serum creatinine.