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Early Evolution and Correlates of Urine Albumin Excretion in Patients Presenting with Acutely Decompensated Heart Failure.


Circ Heart Fail. 2013 Feb 8;


Authors: Koyama S, Sato Y, Tanada Y, Fujiwara H, Takatsu Y


Abstract

BACKGROUND: -Urine albumin excretion (UAE) is an important predictor of adverse cardiovascular events in various populations. Its correlates in patients with acute heart failure (HF) have not been described. METHODS AND RESULTS: -This prospective, observational study included 115 patients presenting with acute HF. The urine albumin / creatinine ratio (UACR) was measured from spot urine samples collected on days 1 and 7 of hospitalization. Median UACR decreased from 83, to 22 mg/gCr on days 1 and 7 respectively (P < 0.0001). The proportion of patients with normoalbuminuria (UACR <30 mg/gCr) increased from 31% on day 1 to 60% on day 7, while the proportion with microalbuminuria (UACR between 30 and 299 mg/gCr) and macroalbuminuria (UACR ≥300 mg/gCr) decreased from, respectively, 42% and 27% on day 1, to 30% and 10% on day 7 (P < 0.0001). These changes in UACR were correlated with changes in serum bilirubin and N-terminal pro b-type natriuretic peptide (NT-pro BNP) concentrations (correlation coefficients 1.087 and 0.384, respectively, 95% confidence intervals 0.394-1.781 and 0.087-0.680, respectively, and P=0.003 and 0.013, respectively) though were not correlated with change in estimated glomerular filtration rate. CONCLUSIONS: -In this sample of patients presenting with acute HF, UAE was often increased upon admission to the hospital and decreased significantly within 7 days of treatment. This decrease was correlated with serum NT-pro BNP and bilirubin concentrations, though neither with baseline nor with changes in indices of renal function.

PMID: 23395932 [PubMed - as supplied by publisher]