NPPB and Abnormal renal physiology: Patients hospitalized with decompensated HF and very high levels of NT-proBNP, above 10,000 pg/mL at admission, are older, have a lower LVEF, higher NYHA class, a higher incidence of renal dysfunction, more extended hospital stay, a higher readmission rate for decompensated HF, with a shorter survival time resulting in a severe clinical profile.