title: Acidic urine is associated with poor prognosis in patients with chronic heart failure.
abstract: Renal dysfunction is reported to be associated with poor outcomes in patients with chronic heart failure (CHF). A recent study showed that acidic urine is related to chronic kidney disease, which is a risk factor for the development of CHF. However, it remains to be determined whether acidic urine is associated with poor outcomes in patients with CHF. We measured urine pH using dipsticks in 537 patients with CHF. Acidic urine was defined as urine pH ≤5.5. Patients were prospectively followed during a median follow-up period of 556 days. There were 145 cardiac events. Prevalence of acidic urine was increased with advancing stage of chronic kidney disease. Patients with acidic urine had a more severe New York Heart Association functional class compared with those with normal urine. In the multivariate Cox proportional hazard analysis, acidic urine was independently associated with poor outcomes in patients with CHF after adjustment of confounding factors. A Kaplan-Meier analysis demonstrated that the rate of cardiac events was higher in patients with acidic urine than in those with normal urine. The presence of acidic urine can reliably identify patients at high risk of future cardiac events in patients with CHF.
authors.affiliation: Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan.
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Otaki
authors.forename: Tetsu
authors.initials: T
authors.lastname: Watanabe
authors.forename: Hiroki
authors.initials: H
authors.lastname: Takahashi
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Hasegawa
authors.forename: Shintaro
authors.initials: S
authors.lastname: Honda
authors.forename: Akira
authors.initials: A
authors.lastname: Funayama
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Netsu
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Ishino
authors.forename: Takanori
authors.initials: T
authors.lastname: Arimoto
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Shishido
authors.forename: Takehiko
authors.initials: T
authors.lastname: Miyashita
authors.forename: Takuya
authors.initials: T
authors.lastname: Miyamoto
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Konta
authors.forename: Isao
authors.initials: I
authors.lastname: Kubota
mesh_terms: D000143:Acids / Q000652:urine*; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000652:urine; D016009:Chi-Square Distribution; D002908:Chronic Disease; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology / Q000652:urine*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011934:Reagent Strips; D012307:Risk Factors; D013997:Time Factors; D016482:Urinalysis / Q000295:instrumentation
chemical_list: D000143:Acids; D015415:Biomarkers; D011934:Reagent Strips