Comorbid renal tubular damage and hypoalbuminemia exacerbate cardiac prognosis in patients with chronic heart failure

Otaki, Yoichiro; Watanabe, Tetsu; Takahashi, Hiroki; Funayama, Akira; Kinoshita, Daisuke; Yokoyama, Masahiro; Takahashi, Toshio; Nishiyama, Satoshi; Arimoto, Takanori; Shishido, Tetsuro; Miyamoto, Takuya; Konta, Tsuneo

doi:10.1007/s00392-015-0899-z

Cited by 14 publications

(15 citation statements)

References 37 publications

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“…9,21,23 On the other hand, urinary tubular markers such as urinary NAG have been shown to be earlier and more sensitive indicators of AKI, suggesting that urinary tubulo-interstitial damage markers could have additional value to evaluate disease severity or association with subsequent adverse events, especially in patients with AHF. Despite most previous studies investigating the relation between tubular damage markers and clinical outcomes in only the compensated phase of HF patients in clinical trials, 9,13,20,23,28 we confirmed its prognostic value in a real-world AHF registry. Thus, we believe that admission urinary NAG could be a useful marker for further risk stratification in patients with AHF.…”

Section: Discussioncontrasting

confidence: 45%

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Elevated admission urinary N-acetyl-β-D-glucosamidase level is associated with worse long-term clinical outcomes in patients with acute heart failure

Funabashi

Omote

Nagai

et al. 2020

European Heart Journal. Acute Cardiovascular Care

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Background: The prognostic significance of urinary N-acetyl-β-D-glucosamidase in acute heart failure has not been fully elucidated. Accordingly, this study investigated whether urinary N-acetyl-β-D-glucosamidase could be associated with subsequent adverse events in acute heart failure patients. Methods: We studied 708 consecutive acute heart failure patients who had accessible N-acetyl-β-D-glucosamidase data on admission from the National Cerebral and Cardiovascular Center Acute Decompensated Heart Failure registry. We assessed the relationship between the admission N-acetyl-β-D-glucosamidase level and the combined endpoint of all-cause death and worsening heart failure. Worsening heart failure was defined as worsening symptoms and signs of heart failure requiring intensification of intravenous therapy such as diuretics, vasodilators and inotropes or initiation of mechanical support after stabilisation with initial treatment during hospitalisation, or readmission due to heart failure after discharge. Results: During a median follow-up period of 763 (interquartile range 431–1028) days, higher urinary N-acetyl-β-D-glucosamidase was significantly related to increased events of all-cause death and worsening heart failure. In addition, patients with higher urinary N-acetyl-β-D-glucosamidase and lower estimated glomerular filtration rate on admission had the worst clinical outcomes. In multivariable Cox regression, urinary N-acetyl-β-D-glucosamidase on admission was independently associated with adverse events (hazard ratio 1.19, 95% confidence interval 1.04–1.35) even after adjustment by covariates including the baseline estimated glomerular filtration rate. Conclusions: Higher urinary N-acetyl-β-D-glucosamidase level on admission was independently associated with worse clinical outcomes. Our findings indicate the potential value of assessing urinary N-acetyl-β-D-glucosamidase on admission for further risk stratification in patients with acute heart failure.

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Section: Discussioncontrasting

confidence: 45%

“…11,12 Among them, urinary N-acetyl-β-Dglucosamidase (NAG) is related to the severity of HF and is associated with worse clinical outcomes in patients with CHF. 9,13 Nevertheless, there is little information on the prognostic value of urinary NAG on admission, especially in relation to long-term outcomes, in hospitalised patients with AHF.…”

Section: Introductionmentioning

confidence: 99%

Elevated admission urinary N-acetyl-β-D-glucosamidase level is associated with worse long-term clinical outcomes in patients with acute heart failure

Funabashi

Omote

Nagai

et al. 2020

European Heart Journal. Acute Cardiovascular Care

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“…The relationship between serum albumin concentration and true GFR may be due, in part, to increased tubular creatinine secretion at lower serum albumin concentrations [27]. Also, lower serum albumin concentration may reflect renal tubular dysfunction impairing protein reabsorption from the filtrate [28], and thus may reflect tubular damage predisposing to development and progression of clinically apparent renal disease. However, this would likely have been reflected by greater urine ACR, and we found that the association of low serum albumin with ESRD events was independent of urine ACR.…”

Section: Discussionmentioning

confidence: 99%

Serum albumin concentration and risk of end-stage renal disease: the REGARDS study

Walther

Gutiérrez

Cushman

et al. 2017

Nephrology Dialysis Transplantation

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“…Lower serum albumin concentration may reflect renal tubular dysfunction impairing protein reabsorption from the filtrate, and thus may reflect tubular damage predisposing to development and progression of clinically apparent renal disease [12,13]. There are two possible explanations for Albumin in PCG was significantly higher than those in HRI.…”

Section: Resultsmentioning

confidence: 99%

The Role of Cystatin C and Albumin in the Differential Diagnosis of Primary Chronic Glomerulonephritis and Hypertension-Induced Renal Injury

Shen¹,

Zhang²,

Zhang³

et al. 2020

Proceedings of the Third International Conference on Social Science, Public Health and Education (SSPHE 2019)

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Background: It was difficult to differentiate diseases in patients of Primary chronic glomerulonephritis (PCG) and Hypertension-induced renal injury (HRI). This study aimed to investigate the role of serum Cystatin C and Albumin in differential diagnosis of PCG and HRI. Materials and Methods: A total of 150 patients (79 PCG and 71 HRI) considering for our clinic between October 2017 and August 2018 were included. Patients were included in the study newly diagnosed by biopsy. Urinary samples and blood samples were collected and measured. The diagnostic roles were investigated using the receiver operator curve curves. Results: There was an increased serum levels of Albumin in patients with PCG compared with that in patients with HRI. Patients with HRI had a significantly increased serum levels of Cystatin C than those with PCG. An Albumin level of 2.295 g/L had an 80.3% sensitivity and a 73.4% specificity, Cystatin C level of 36.200 mg/L had a 79.7% sensitivity and a 93% specificity for differential diagnosis of PCG and HRI. Conclusions: Serum Cystatin C and Albumin level might be used as tool to differentiate PCG from HRI. Further studies are needed to confirm the definite the role of those markers.

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Comorbid renal tubular damage and hypoalbuminemia exacerbate cardiac prognosis in patients with chronic heart failure

Abstract: Comorbid RTD and hypoalbuminemia are frequently observed and increase the risk for extremely poor outcome in patients with CHF.

Cited by 14 publications

References 37 publications

Elevated admission urinary N-acetyl-β-D-glucosamidase level is associated with worse long-term clinical outcomes in patients with acute heart failure

Elevated admission urinary N-acetyl-β-D-glucosamidase level is associated with worse long-term clinical outcomes in patients with acute heart failure

Serum albumin concentration and risk of end-stage renal disease: the REGARDS study

The Role of Cystatin C and Albumin in the Differential Diagnosis of Primary Chronic Glomerulonephritis and Hypertension-Induced Renal Injury

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