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Urinary cast is a useful predictor of acute kidney injury in acute heart failure

Satoshi Higuchi1, Yusuke Kabeya2,3, Kenichi Matsushita4

  • 1Division of Cardiology, Department of Internal Medicine II, Kyorin University School of Medicine, Tokyo, Japan. sahiguchi-circ@umin.ac.jp.

Scientific Reports
|March 15, 2019
PubMed

Insights

Cellular casts in urine may predict hospital-acquired acute kidney injury (AKI) in patients with acute heart failure (AHF). Early detection of these casts could aid in risk reduction for AKI development.

Area of Science:

  • Nephrology
  • Cardiology
  • Internal Medicine

Background:

  • Acute kidney injury (AKI) significantly worsens outcomes for patients with acute heart failure (AHF).
  • Early identification of kidney function impairment is crucial for risk mitigation in AHF patients.

Purpose of the Study:

  • To investigate the association between the presence of cellular casts and the development of hospital-acquired AKI in patients admitted for AHF.
  • To determine if urinary sediment analysis can serve as an early indicator for AKI in this population.

Main Methods:

  • A cohort of 114 patients with AHF underwent urinalysis and urinary sediment analysis within 24 hours of admission.
  • AKI was defined by standard creatinine-based criteria (≥0.3 mg/dL increase within 48h or ≥1.5-fold baseline).
  • Multivariate logistic regression was used to assess the relationship between cellular casts and hospital-acquired AKI.

Main Results:

  • Of the 114 AHF patients, 40 (35%) developed hospital-acquired AKI.
  • Cellular casts were identified in 30 patients (26%) before AKI onset.
  • The presence of cellular casts was significantly associated with hospital-acquired AKI (OR, 2.80; 95% CI, 1.04-7.49; P=0.041).

Conclusions:

  • Cellular casts are an occasional finding in patients with AHF.
  • The presence of cellular casts may serve as a valuable predictive marker for the development of AKI during hospitalization in AHF patients.

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