Urinary Cell Cycle Arrest Biomarkers and Diuretic Efficiency in Acute Heart Failure

Abstract

<b><i>Introduction:</i></b> This study aimed to evaluate the association between the NephroCheck^® test AKIRisk^® score, diuretic efficiency (DE), and the odds of worsening kidney function (WKF) within the first 72 h of admission in patients hospitalized for acute heart failure (AHF). <b><i>Methods:</i></b> The study prospectively enrolled 125 patients admitted with AHF. NephroCheck^® test was obtained within the first 24 h of admission. DE was defined as net fluid urine output per 40 mg of furosemide equivalents. <b><i>Results:</i></b> The median AKIRisk^® score was 0.11 (IQR 0.06–0.34), and 38 (30.4%) patients had an AKIRisk^® score &gt;0.3. The median cumulative DE at 72 h was 1,963 mL (IQR 1317–3,239 mL). At 72 h, a total of 10 (8%) patients developed an absolute increase in sCr ≥0.5 mg/dL (WKF). In a multivariable setting, there was an inverse association between the AKIRisk^® score and DE within the first 72 h. In fact, the highest the AKIRisk^® score (centered at 0.3), the higher the likelihood of poor DE (below the median) and WKF at 72 h (odds ratio [OR] 2.04; 95%; CI: 1.02–4.07; <i>p</i> = 0.043, and OR 3.31, 95% CI: 1.30–8.43; <i>p</i> = 0.012, respectively). <b><i>Conclusion:</i></b> In patients with AHF, a higher NephroCheck^® AKIRisk^® score is associated with poorer DE and a higher risk of WKF at 72 h. Further research is needed to confirm the role of urinary cell cycle arrest biomarkers in the AHF scenario.