[Predictive value of proteinuria for in-hospital severe adverse events and prognosis of the patients with heart failure].

OBJECTIVE: To investigate the effect of proteinuria on in-hospital severe adverse events and prognosis of the patients with heart failure(HF).

METHODS: Clinical data of 520 patients with severe HF( NYHA 3-4 grades) in our department were analyzed retrospectively. Proteinuria was diagnosed on admission using the spot dipstick urinalysis. Clinical characteristics were compared between the patients with and without proteinuria. Univariate and multivariate Logistic regression analysis were used to evaluate the correlations of proteinuria with in-hospital adverse events and prognosis.

RESULTS: On admission, proteinuria was found in 57.7% (300/520) of the enrolled patients with severe HF. The age, proportions of the HF patients coexistent with hypertention, diabetes mellitus and aneamia, and receiving vasoactive drugs, levels of NT-proBNP, creatinine, C-reactive protein and fasting blood glucose, were significantly higher, while the levels of eGFR, hemoglobin and hematocrit significantly lower in the proteinuria group than those in the non- proteinuria group. The multivariate analysis revealed that proteinuria was an independent risk factor for mechanical ventilation (MV) (OR=2.916, 95% CI: 1.712-4.968, P<0.001), cardiopulmonary resuscitation (CPR) (OR=1.956, 95% CI: 0.997-3.843, P=0.049) and in-hospital mortality (OR=2.490, 95% CI: 1.188-5.218, P=0.016).

CONCLUSIONS: The severe HF patients with proteinuria often present with severe critical conditions. Proteinuria should be a potential marker for in-hospital adverse events and prognosis of severe hospitalized HF patients.