Key Points
- To determine whether urinary biomarkers of tubular stress and congestion correlate with diuretic responsiveness in patients hospitalized for acute heart failure.
- Analyzed N=134 patients hospitalized with acute heart failure.
- Quantified diuretic response as body weight change over the first 3 days per 40 mg furosemide equivalent (multiplied by −1), standardizing azosemide 60 mg and torasemide 8 mg to furosemide 40 mg with oral bioavailability adjusted by 0.5.
- Measured urinary L-FABP, NGAL, and adrenomedullin (tAM) normalized to urinary creatinine within 3 days of admission, assessing associations via Spearman correlation and multivariable ordinary least squares regression.
- Spearman correlation coefficients with diuretic response were weak: L-FABP (r = −0.0142, p = 0.8796), NGAL (r = 0.0203, p = 0.8703), and tAM (r = −0.0189, p = 0.8395).
- Boxplots across diuretic response quartiles showed overlapping distributions without significant trends (p for trend: L-FABP = 0.8013, NGAL = 0.5825, tAM = 0.064).
- In multivariable regression Model 1, standardized β (95% CI) values were 0.044 (−0.256 to 0.344) for L-FABP, −0.005 (−0.303 to 0.292) for NGAL, and 0.057 (−0.206 to 0.319) for tAM.
Urinary biomarkers of tubular stress and congestion (L-FABP, NGAL, tAM) do not significantly correlate with diuretic response in patients hospitalized for acute heart failure.