Dipstick proteinuria is a prognostic indicator of short-term mortality in patients with heart failure

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.

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.

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.

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.