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Updated: May 16, 2026

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
05:16

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure

Published on: June 10, 2025

Urinary potassium/urinary creatinine ratio in outpatients with heart failure: factors associated and prognostic

Gema Miñana1,2, Neus Valls3, Miguel Lorenzo1

  • 1Cardiology Department, Hospital Clínico Universitario, Universitat de Valencia, INCLIVA, Valencia, Spain.

Scientific Reports
|May 14, 2026
PubMed

Insights

The spot urinary potassium-to-creatinine ratio in heart failure (HF) patients is linked to kidney function and diuretic use. Higher ratios predict increased mortality, aiding HF risk assessment.

Area of Science:

  • Cardiology
  • Nephrology
  • Clinical Biochemistry

Background:

  • The spot urinary potassium-to-creatinine (uK/uCr) ratio is a potential surrogate for 24-hour potassium excretion in heart failure (HF).
  • Clinical determinants and prognostic value of uK/uCr in ambulatory HF patients are not well-established.

Purpose of the Study:

  • To evaluate clinical variables associated with the uK/uCr ratio in HF patients.
  • To assess the relationship between the uK/uCr ratio and long-term mortality in ambulatory HF patients.

Main Methods:

  • Ambispective analysis of 1,145 ambulatory HF patients from a single-center HF clinic.
  • Multivariable linear regression identified factors associated with uK/uCr.
  • Cox models assessed the prognostic value of uK/uCr for mortality.

Main Results:

  • Higher uK/uCr was independently associated with estimated glomerular filtration rate, furosemide dose, BUN, age, and NT-proBNP.
  • Each 10-unit increase in uK/uCr correlated with increased all-cause mortality (HR 1.031) and cardiovascular mortality (HR 1.039).
  • The uK/uCr ratio explained significant variance in associated clinical factors (e.g., eGFR 28.3%, furosemide 20.6%).

Conclusions:

  • The uK/uCr ratio reflects renal function, diuretic intensity, and neurohormonal activation in HF.
  • The uK/uCr ratio is an independent predictor of mortality in HF patients.
  • This ratio may aid in risk stratification and therapeutic decisions for HF management.

Keywords:
Heart failureHiperpotasemiaPrognosisUrinary potassium excretionUrinary potassium/urinary creatinine ratio

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