Dipstick proteinuria is a prognostic indicator of short-term mortality in patients with heart failure

详细信息    查看全文

• 作者：Yuanhan Chen^a ; Lu Cai^a ; Zhiming Du^b ; Jiaqi Xu^c ; Ning Tan^d ; Zhiming Ye^a ; Shuangxin Liu^a ; Wei Dong^a ; Wei Shi^a ; ^{ssweicn@163.com} ; Xinling Liang^a ; ^{xinlingliang@139.com}
• 关键词：AHF ; Acute heart failure ; CKD ; chronic kidney disease ; eGFR ; estimated glomerular filtration rate ; RRT ; renal replacement therapy ; ECG ; electrocardiogram ; NT-proBNP ; N-terminal pro-brain natriuretic peptide ; CRP ; C-reactive protein ; EFFECT ; Enhanced Feedback for Effective Cardiac Treatment
• 刊名：International Journal of Cardiology
• 出版年：2017
• 出版时间：1 March 2017
• 年：2017
• 卷：230
• 期：Complete
• 页码：59-63
• 全文大小：348 K
• 卷排序：230

文摘

Proteinuria is common in patients with acute heart failure (AHF). This study investigated the relationship between proteinuria and short-term mortality among patients hospitalized for AHF at two university hospitals.MethodsAdult hospitalized patients with AHF were retrospectively studied. Proteinuria was defined based on the first urine dipstick test within 48 h after the AHF diagnosis. The death risk was assessed using an Enhanced Feedback for Effective Cardiac Treatment (EFFECT) 30-day mortality risk score.ResultsOf the 1,058 eligible patients with AHF, 583 (55.1%) exhibited proteinuria. The degree of proteinuria was positively correlated with poor AHF prognostic indicators (C-reactive protein and N-terminal pro-brain natriuretic peptide) and negatively correlated with protective indicators (basal estimated glomerular filtration rate, haemoglobin, and serum albumin). The EFFECT mortality risk score and the in-hospital mortality rate of patients with proteinuria were significantly higher than that of the patients without proteinuria. According to different multivariate logistic regression models, proteinuria increased the risk of in-hospital mortality after correcting for multiple variables, including the EFFECT mortality risk score, diabetes, RASI, NT-proBNP, albumin and chronic kidney disease stages. Compared with the NT-proBNP, proteinuria and degree of proteinuria yielded higher areas under the ROC curve for predicting in-hospital mortality.ConclusionsOur results demonstrate that proteinuria correlates with the short-term mortality rate of patients hospitalized for AHF. Dipstick proteinuria testing might represent a promising prognostic indicator for these patients.