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Early Post-Discharge Albuminuria Trajectory and Clinical Outcomes After Acute Heart Failure
Mario Galván-Ruiz1,2, Patricia Nogueira-Salgueiro3, Jonathan Déniz-Rosario1
1Cardiology Department, Hospital Universitario de Gran Canaria Doctor Negrín, 35016 Las Palmas de Gran Canaria, Spain.
Journal of Clinical Medicine
|August 13, 2026
Summary
Persistent albuminuria after acute heart failure (AHF) hospitalization indicates a higher risk of readmission and mortality. Early reduction in urine albumin-to-creatinine ratio (UACR) suggests better outcomes, aiding risk stratification.
Area of Science:
- Cardiology
- Nephrology
- Clinical Medicine
Background:
- Albuminuria is a known marker for cardiovascular and renal risk.
- It may reflect hemodynamic changes in acute heart failure (AHF).
- The prognostic value of early urine albumin-to-creatinine ratio (UACR) monitoring post-discharge in AHF is unclear.
Purpose of the Study:
- To investigate the prognostic value of UACR trajectory in patients hospitalized for AHF.
- To assess the association between UACR changes and clinical outcomes post-discharge.
- To determine if UACR monitoring can improve risk stratification in the vulnerable post-discharge phase.
Main Methods:
- Prospective single-centre study of 88 AHF patients.
- UACR measured at discharge and 2-week follow-up.
- Patients stratified by UACR trajectory: persistent normoalbuminuria, reducing/normalizing microalbuminuria, or persistent microalbuminuria/macroalbuminuria.
Main Results:
- Albuminuria was prevalent in 64.8% of patients.
- Persistent albuminuria (Group 3) was associated with higher comorbidity burden, worse renal function, and higher congestion markers.
- Group 3 showed a significantly higher incidence of HF readmissions and composite endpoints (HF readmission or all-cause mortality) in multivariable analysis.
Conclusions:
- Albuminuria is common in AHF and linked to hemodynamic congestion.
- Persistent albuminuria identifies a high-risk phenotype post-discharge.
- Early UACR reduction is linked to better outcomes, suggesting UACR trajectory aids risk stratification.
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