Congestion as a crucial factor determining albuminuria in patients with cardiorenal disease.

Autor: Llàcer P; Internal Medicine Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain.; Department of Medicine and Medical Specialties, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, Madrid, Spain., Cobo Marcos M; Department of Cardiology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.; Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain., de la Espriella R; Department of Cardiology, Hospital Clínico Universitario de Valencia, Valencia, Spain., Gayán Ordás J; Department of Cardiology, Hospital Universitario Arnau de Vilanova, Institut de Recerca Biomèdica de Lleida, Lleida, Spain., Zegri I; Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain., Fort A; Department of Cardiology, Hospital Universitari Dr Josep Trueta, Girona, Spain., Rodríguez Chavarri A; Department of Cardiology, Hospital Universitario La Paz, Madrid, Spain., Méndez A; Department of Cardiology, Hospital Universitario Vall d'Hebron, Barcelona, Spain., Blázquez Z; Department of Cardiology, Hospital Universtiario Gregorio Marañón, Madrid, Spain., Caravaca Pérez P; Department of Cardiology, Hospital Universitario Doce de Octubre, Madrid, Spain., Rubio Gracia J; Department of Internal Medicine, Hospital Universitario Lozano Blesa, University of Zaragoza, Zaragoza, Spain., Fernández C; Internal Medicine Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain.; Department of Medicine and Medical Specialties, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, Madrid, Spain., Recio-Mayoral A; Department of Cardiology, Hospital Universitario Virgen Macarena, Sevilla, Spain., Pomares A; Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain., García Pinilla JM; Department of Cardiology, Hospital Universitario Virgen de la Victoria, Málaga, Spain., Vazquez López-Ibor J; Department of Cardiology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain., Castro A; Department of Cardiology, Hospital Universitario La Paz, Madrid, Spain., Soler MJ; Department of Nephrology, Hospital Universitario Vall d´Hebron, Barcelona, Spain., Górriz JL; Department of Nephrology, Hospital Clínico Universitario Valencia, University of Valencia, Valencia, Spain., Bascompte Claret R; Department of Cardiology, Hospital Universitario Arnau de Vilanova, Institut de Recerca Biomèdica de Lleida, Lleida, Spain., Fluvià P; Department of Cardiology, Hospital Universitari Dr Josep Trueta, Girona, Spain., Manzano L; Internal Medicine Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain.; Department of Medicine and Medical Specialties, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, Madrid, Spain., Núñez J; Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain.; Department of Cardiology, Hospital Clínico Universitario de Valencia, Valencia, Spain.
Jazyk: angličtina
Zdroj: Clinical kidney journal [Clin Kidney J] 2024 May 15; Vol. 17 (6), pp. sfae140. Date of Electronic Publication: 2024 May 15 (Print Publication: 2024).
DOI: 10.1093/ckj/sfae140
Abstrakt: Background: Albuminuria could potentially emerge as a novel marker of congestion in acute heart failure. However, the current evidence linking albuminuria and congestion in patients with congestive heart failure (CHF) remains somewhat scarce. This study aimed to evaluate the prevalence of albuminuria in a cohort of patients with CHF, identify the independent factors associated with albuminuria and analyse the correlation with different congestion parameters.
Methods: This is a subanalysis of the Spanish Cardiorenal Registry, in which we enrolled 864 outpatients with heart failure and a value of urinary albumin:creatinine ratio (UACR) at the first visit.
Results: The median age was 74 years, 549 (63.5%) were male and 438 (50.7%) had a reduced left ventricular ejection fraction. A total of 350 patients (40.5%) had albuminuria. Among these patients, 386 (33.1%) had a UACR of 30-300 mg/g and 64 (7.4%) had a UACR >300 mg/g. In order of importance, the independent variables associated with higher UACR were estimated glomerular filtration rate determined by the Chronic Kidney Disease Epidemiology Collaboration equation ( R 2  = 57.6%), systolic blood pressure ( R 2  = 21.1%), previous furosemide equivalent dose (FED; R 2  = 7.5%), antigen carbohydrate 125 (CA125; R 2  = 6.1%), diabetes mellitus ( R 2  = 5.6%) and oedema ( R 2  = 1.9%). The combined influence of oedema, elevated CA125 levels and the FED accounted for 15.5% of the model's variability.
Conclusions: In patients with chronic stable heart failure, the prevalence of albuminuria is high. The risk factors of albuminuria in this population are chronic kidney disease and hypertension. Congestion parameters are also associated with increased albuminuria.
Competing Interests: M.J.S. and J.N. are members of the CKJ editorial board.
(© The Author(s) 2024. Published by Oxford University Press on behalf of the ERA.)
Databáze: MEDLINE
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