CoChat
Sign Up
Cited by 70

The DOI matches its Crossref record.

Albuminuria as a marker of systemic congestion in patients with heart failure

Boorsma, Eva M, ter Maaten, Jozine M, Damman, Kevin, van Essen, Bart J, Zannad, Faiez, van Veldhuisen, Dirk J, Samani, Nilesh J, Dickstein, Kenneth, Metra, Marco, Filippatos, Gerasimos, Lang, Chim C, Ng, Leong, Anker, Stefan D, Cleland, John G, Pellicori, Pierpaolo, Gansevoort, Ron T, Heerspink, Hiddo J L, Voors, Adriaan A, Emmens, Johanna E·2023·European Heart Journal
DOI 10.1093/eurheartj/ehac528PMC PMC9890244
Open this paper in CoChat — free account

Abstract

Aims: Albuminuria is common in patients with heart failure and associated with worse outcomes. The underlying pathophysiological mechanism of albuminuria in heart failure is still incompletely understood. The association of clinical characteristics and biomarker profile with albuminuria in patients with heart failure with both reduced and preserved ejection fractions were evaluated. Methods and results: Two thousand three hundred and fifteen patients included in the index cohort of BIOSTAT-CHF were evaluated and findings were validated in the independent BIOSTAT-CHF validation cohort (1431 patients). Micro-albuminuria and macro-albuminuria were defined as urinary albumin–creatinine ratio (UACR) >30 mg/gCr and >300 mg/gCr in spot urines, respectively. The prevalence of micro- and macro-albuminuria was 35.4% and 10.0%, respectively. Patients with albuminuria had more severe heart failure, as indicated by inclusion during admission, higher New York Heart Association functional class, more clinical signs and symptoms of congestion, and higher concentrations of biomarkers related to congestion, such as biologically active adrenomedullin, cancer antigen 125, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) (all P < 0.001). The presence of albuminuria was associated with increased risk of mortality and heart failure (re)hospitalization in both cohorts. The strongest independent association with log UACR was found for log NT-proBNP (standardized regression coefficient 0.438, 95% confidence interval 0.35–0.53, P < 0.001). Hierarchical clustering analysis demonstrated that UACR clusters with markers of congestion and less with indices of renal function. The validation cohort yielded similar findings. Conclusion: In patients with new-onset or worsening heart failure, albuminuria is consistently associated with clinical, echocardiographic, and circulating biomarkers of congestion.

Overview

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1093/eurheartj/ehac528

Cites

Statistics

Verification

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Endothelial dysfunction, inflammation and CKD in HFpEF can underlie the development of microalbuminuria, which is correlated with greater cardiac dysfunction and congestion, along with higher risk for HF hospitalization or death.

    “Endothelial dysfunction, inflammation and CKD in HFpEF can underlie the development of microalbuminuria, which is correlated with greater cardiac dysfunction and congestion, along with higher risk for HF hospitalization or death10–12.”

    From Effects of tirzepatide on circulatory overload and end-organ damage in heart failure with preserved ejection fraction and obesity: a secondary analysis of the SUMMIT trial (2025) · cites this paper as [12]

    The Discussion (Endothelial dysfunction; Congestion) proposes endothelial dysfunction as a possible cause of albuminuria and reports correlations with congestion, while cautioning that causality cannot be assessed. The Results (Cox regression analysis) associate albuminuria with mortality and heart-failure hospitalization and find no significant difference in that association between HFpEF and HFrEF. The copy does not establish inflammation or CKD as causes of microalbuminuria in HFpEF, or specifically demonstrate the claimed link with greater cardiac dysfunction in HFpEF. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Citations

Cites

No references could be resolved yet.

Research works printed but not linked: 34

  1. Satchell, 2013, The role of the glomerular endothelium in albumin handling, Nat Rev Nephrol, 9, 717, 10.1038/nrneph.2013.197 · DOI
  2. Ritz, 1994, Proteinuria and hypertension, Kidney Int Suppl, 47, 76
  3. Selby, 2020, An updated overview of diabetic nephropathy: diagnosis, prognosis, treatment goals and latest guidelines, Diabetes Obes Metab, 22, 3, 10.1111/dom.14007 · DOI
  4. Jackson, 2009, Albuminuria in chronic heart failure: prevalence and prognostic importance, Lancet, 374, 543, 10.1016/S0140-6736(09)61378-7 · DOI
  5. Masson, 2010, Prevalence and prognostic value of elevated urinary albumin excretion in patients with chronic heart failure: data from the GISSI-Heart Failure trial, Circ Heart Fail, 3, 65, 10.1161/CIRCHEARTFAILURE.109.881805 · DOI
  6. Che, 2020, Angiotensin II promotes podocyte injury by activating Arf6-Erk1/2-Nox4 signaling pathway, PLoS One, 15, 10.1371/journal.pone.0229747 · DOI
  7. Doty, 1999, Effect of increased renal venous pressure on renal function, J Trauma, 47, 1000, 10.1097/00005373-199912000-00002 · DOI
  8. Doty, 2000, Effects of increased renal parenchymal pressure on renal function, J Trauma, 48, 874, 10.1097/00005373-200005000-00010 · DOI
  9. Dobre, 2009, Albuminuria in heart failure: what do we really know?, Curr Opin Cardiol, 24, 148, 10.1097/HCO.0b013e328323aa9a · DOI
  10. Butler, 2019, Aldosterone induces albuminuria via matrix metalloproteinase-dependent damage of the endothelial glycocalyx, Kidney Int, 95, 94, 10.1016/j.kint.2018.08.024 · DOI
  11. Katz, 2014, Albuminuria is independently associated with cardiac remodeling, abnormal right and left ventricular function, and worse outcomes in heart failure with preserved ejection fraction, JACC Heart Fail, 2, 586, 10.1016/j.jchf.2014.05.016 · DOI · Paper page
  12. Voors, 2016, A systems BIOlogy study to TAilored treatment in chronic heart failure: rationale, design, and baseline characteristics of BIOSTAT-CHF, Eur J Heart Fail, 18, 716, 10.1002/ejhf.531 · DOI
  13. McDonagh, 2021, 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure, Eur Heart J, 42, 3599, 10.1093/eurheartj/ehab368 · DOI · Paper page
  14. Friedman, 2010, Regularization paths for generalized linear models via coordinate descent, J Stat Softw, 33, 1, 10.18637/jss.v033.i01 · DOI · Paper page
  15. Voors, 2017, Development and validation of multivariable models to predict mortality and hospitalization in patients with heart failure, Eur J Heart Fail, 19, 627, 10.1002/ejhf.785 · DOI
  16. Ambrosy, 2013, Clinical course and predictive value of congestion during hospitalization in patients admitted for worsening signs and symptoms of heart failure with reduced ejection fraction: findings from the EVEREST trial, Eur Heart J, 34, 835, 10.1093/eurheartj/ehs444 · DOI
  17. Núñez, 2020, Clinical role of CA125 in worsening heart failure: a BIOSTAT-CHF study subanalysis, JACC Heart Fail, 8, 386, 10.1016/j.jchf.2019.12.005 · DOI
  18. Wegria, 1955, The pathogenesis of proteinuria in the acutely congested kidney, J Clin Invest, 34, 737, 10.1172/JCI103127 · DOI
  19. Sakaguchi, 2020, Relationship of central venous pressure to body fluid volume status and its prognostic implication in patients with acute decompensated heart failure, J Card Fail, 26, 15, 10.1016/j.cardfail.2018.06.001 · DOI
  20. Sperry, 2017, Peripheral venous pressure measurements in patients with acute decompensated heart failure (PVP-HF), Circ Heart Fail, 10, e004130, 10.1161/CIRCHEARTFAILURE.117.004130 · DOI
  21. Koyama, 2013, Early evolution and correlates of urine albumin excretion in patients presenting with acutely decompensated heart failure, Circ Heart Fail, 6, 227, 10.1161/CIRCHEARTFAILURE.112.000152 · DOI
  22. Gulleroglu, 2014, Nutcracker syndrome, World J Nephrol, 3, 277, 10.5527/wjn.v3.i4.277 · DOI
  23. Asghar, 2007, Renal vein thrombosis, Eur J Vasc Endovasc Surg, 34, 217, 10.1016/j.ejvs.2007.02.017 · DOI
  24. Rajpal, 2018, Association of albuminuria with major adverse outcomes in adults with congenital heart disease: results from the Boston adult congenital heart biobank, JAMA Cardiol, 3, 308, 10.1001/jamacardio.2018.0125 · DOI
  25. Castro, 2008, Pulmonary hypertension associated with sickle cell disease: clinical and laboratory endpoints and disease outcomes, Am J Hematol, 83, 19, 10.1002/ajh.21058 · DOI
  26. Burnett, 1980, Renal interstitial pressure and sodium excretion during renal vein constriction, Am J Physiol, 238, 279
  27. Shimada, 2018, Pathophysiological and molecular mechanisms involved in renal congestion in a novel rat model, Sci Rep, 8, 16808, 10.1038/s41598-018-35162-4 · DOI
  28. Damman, 2018, Renal effects and associated outcomes during angiotensin-neprilysin inhibition in heart failure, JACC Heart Fail, 6, 489, 10.1016/j.jchf.2018.02.004 · DOI
  29. Pieske, 2021, Effect of sacubitril/valsartan vs standard medical therapies on plasma NT-proBNP concentration and submaximal exercise capacity in patients with heart failure and preserved ejection fraction: the PARALLAX randomized clinical trial, JAMA, 326, 1919, 10.1001/jama.2021.18463 · DOI
  30. Zhang, 2018, Endothelial cell dysfunction and glycocalyx—a vicious circle, Matrix Biol, 71–72, 421, 10.1016/j.matbio.2018.01.026 · DOI
  31. Martens, 2018, Microvascular endothelial dysfunction is associated with albuminuria: the Maastricht Study, J Hypertens, 36, 1178, 10.1097/HJH.0000000000001674 · DOI
  32. Boorsma, 2020, Congestion in heart failure: a contemporary look at physiology, diagnosis and treatment, Nat Rev Cardiol, 17, 641, 10.1038/s41569-020-0379-7 · DOI
  33. Nijst, 2015, The pathophysiological role of interstitial sodium in heart failure, J Am Coll Cardiol, 65, 378, 10.1016/j.jacc.2014.11.025 · DOI
  34. Ataga, 2010, Urinary albumin excretion is associated with pulmonary hypertension in sickle cell disease: potential role of soluble fms-like tyrosine kinase-1, Eur J Haematol, 85, 257, 10.1111/j.1600-0609.2010.01471.x · DOI

Cited by

Sorted by citations

Metadata

Authors
Boorsma, E. M., ter Maaten, J. M., Damman, K., van Essen, B. J., Zannad, F., van Veldhuisen, D. J., Samani, N. J., Dickstein, K., Metra, M., Filippatos, G., Lang, C. C., Ng, L., Anker, S. D., Cleland, J. G., Pellicori, P., Gansevoort, R. T., Heerspink, H. J. L., Voors, A. A., & Emmens, J. E.
Venue
European Heart Journal
Publisher
Oxford University Press (OUP)
Published
2022-09-23
Volume
44
Issue
5
Pages
368-380
ISSN
  • 0195-668X
  • 1522-9645
DOI
10.1093/eurheartj/ehac528
PMC
PMC9890244
Cited by
70
References
0
Language
en
Licence
creativecommons.org/licenses/by-nc/4.0/ (vor)

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review