title: Dipstick proteinuria is a prognostic indicator of short-term mortality in patients with heart failure.
abstract: BACKGROUND
  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.
  
  
  METHODS
  Adult 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.
  
  
  RESULTS
  Of 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.
  
  
  CONCLUSIONS
  Our 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.
authors.affiliation: Divisionof Nephrology, Guangdong General Hospital, Guangdong Academic of Medical Sciences, Guangzhou, 510080, China.
authors.forename: Yuanhan
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Divisionof Nephrology, Guangdong General Hospital, Guangdong Academic of Medical Sciences, Guangzhou, 510080, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Cai
authors.affiliation: Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China.
authors.forename: Zhiming
authors.initials: Z
authors.lastname: Du
authors.affiliation: Department of Nephrology, Huadu District, Guangzhou City People's Hospital, Guangzhou, 510080, China.
authors.forename: Jiaqi
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academic of Medical Sciences, Guangzhou, 510080, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Tan
authors.affiliation: Divisionof Nephrology, Guangdong General Hospital, Guangdong Academic of Medical Sciences, Guangzhou, 510080, China.
authors.forename: Zhiming
authors.initials: Z
authors.lastname: Ye
authors.affiliation: Divisionof Nephrology, Guangdong General Hospital, Guangdong Academic of Medical Sciences, Guangzhou, 510080, China.
authors.forename: Shuangxin
authors.initials: S
authors.lastname: Liu
authors.affiliation: Divisionof Nephrology, Guangdong General Hospital, Guangdong Academic of Medical Sciences, Guangzhou, 510080, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Dong
authors.affiliation: Divisionof Nephrology, Guangdong General Hospital, Guangdong Academic of Medical Sciences, Guangzhou, 510080, China. Electronic address: ssweicn@163.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Shi
authors.affiliation: Divisionof Nephrology, Guangdong General Hospital, Guangdong Academic of Medical Sciences, Guangzhou, 510080, China. Electronic address: xinlingliang@139.com.
authors.forename: Xinling
authors.initials: X
authors.lastname: Liang
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000401:mortality* / Q000652:urine*; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011507:Proteinuria / Q000150:complications / Q000175:diagnosis / Q000401:mortality*; D012189:Retrospective Studies; D015996:Survival Rate; D016482:Urinalysis
keywords: acute heart failure; marker; mortality; prognostic indicator; proteinuria