What the study examined
The analysis included 3,107 patients in the JROADHF-NEXT registry whose stored discharge urine samples allowed UACR measurement. Median age was 76 years and 62% were men. Patients were grouped as A1 (<30 mg/gCr), A2 (30–300) and A3 (>300).
Key results
After adjustment for age, sex and discharge eGFR, one-year eGFR changes were −2.4, −4.2 and −5.1 mL/min/1.73m² in A1, A2 and A3. During two years, kidney-related events occurred in 195 patients (6.3%): 4.6%, 7.5% and 13.6% across the three groups. Adjusted odds ratios versus A1 were 1.83 for A2 and 3.69 for A3. Higher UACR also remained associated with all-cause mortality after adjustment for established heart-failure risk measures.
What it means
UACR is a relatively simple urine measurement. It may add cardiorenal risk information at discharge and support decisions about follow-up intensity, but it should not be used alone to diagnose disease or determine treatment.
For a second-opinion record
Prepare the heart-failure phenotype, congestion status, eGFR, UACR, diabetes and hypertension history, medications and readmissions in chronological order. Cardiac and renal status should be interpreted together.