Clinical Lab News – Urinalysis to Monitor Changes in Kidney Health Markers May Predict New Onset Heart Failure – Clinical Chemistry

Urinalysis to track changes in markers of kidney health may predict new onset heart failure

From the editors of LabMedica in Spanish
Updated August 06, 2023

Heart failure, a disease that affects one in five people during their lifetime, is largely due to kidney failure. Thus, monitoring indicators of kidney health in people predisposed to heart failure is standard practice. While short-term fluctuations in renal biomarkers are well known, the relationship between long-term biomarker patterns and heart failure risk remains to be understood. Now researchers have discovered a key treatment target that could prevent patients from developing serious heart disease in the future.

In a new study, an international research team led by Osaka University (Suita, Japan) has successfully identified long-term trends in kidney health outcomes in healthy European adults and how these patterns affect the risk of developing heart failure. The study included two common markers of kidney health, urinary albumin excretion (UAE) and serum creatinine, in nearly 7,000 participants in the Dutch Prevention of End-Stage Renal and Vascular Disease (PREVEND) study. The team tracked trends in UAE and serum creatinine over 11 years, investigating their correlation with new onset heart failure and death.

Image: Monitoring changes in longitudinal urinalysis can help predict heart failure (Source: R. Sakaniva et al. European Journal of Heart Failure 2023)

The study clearly showed that the majority of participants had persistently low serum UAE or creatinine levels, but those with persistently high UAE levels had a significantly increased risk of developing heart failure or all-cause mortality. Interestingly, annual levels of renal biomarkers remained remarkably stable from last year during the 11-year follow-up period. Stable serum creatinine over time correlated with heart failure but not with an increased risk of death. Further analysis showed that people with persistently higher serum creatinine or EAE were more likely to be older, male, and have medical conditions such as diabetes, a previous heart attack, or dyslipidaemia. The study suggests that reducing UAE may help reduce the risk of heart failure and death in these patients in the future. Given that heart failure can affect one in five people in a lifetime, these findings could have a significant impact on preventive medicine, and further testing of these findings in non-European populations is required.

“Our results highlight the importance of the heart-kidney connection in heart failure, showing that patients with persistently deteriorating kidney function, as evidenced by higher serum UAE or creatinine, are at increased risk of heart failure or mortality,” said Dr. Rioto. Sakaniva, lead author of the study. “Reducing these renal biomarkers may help prevent heart failure.”

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