Association between serum albumin to serum creatinine ratio and incident heart failure in patients with chronic kidney disease

This prospective cohort study investigated the association between the albumin to serum creatinine ratio (sACR) and heart failure (HF) incidence in 150 chronic kidney disease (CKD) patients. Over a median 23-month follow-up, 114 HF events occurred. Multivariate Cox regression revealed a higher HF risk in the lowest versus highest sACR tertile (adjusted HR=1.742, 95% CI=1.341–2.002, p=0.023). Lower sACR correlated with worsened cardiac structure/function. The predictive AUC for HF was 0.64 for sACR alone and improved to 0.79 when combined with clinical covariates. We conclude that low sACR is independently associated with increased HF incidence in CKD patients.