Levels of a protein in the urine, urinary angiotensinogen (uAGT), may help clinicians predict which patients with acute heart failure are at increased risk of developing acute kidney injury (AKI) during hospitalization, revealed a new study.
Acute heart failure is the leading cause of hospitalizations worldwide and in patients with acute decompensated heart failure (ADHF), which occurs when symptoms in people with previous or existing heart problems get worse, 25% to 51% develop AKI due to connections between the heart and kidneys. Unfortunately, there are is no reliable clinical marker to help clinicians predict which patients are at high risk of developing AKI.
Researchers conducted a study in 436 patients with ADHF to validate a new marker uAGT, which plays an important role in blood pressure regulation and kidney health, for predicting patients' risk of developing AKI. The team found that uAGT levels at the time of hospital admission predicted AKI risk with considerable accuracy. The highest quartile of uAGT on admission was linked with a 50-times elevated risk of AKI compared with the lowest quartile. Patients' uAGT level at the time of admission also helped clinicians predict patients' risk of being re-hospitalized or dying within a year.
Researcher Fan Fan Hou said, "Our results raise the possibility that by using sensitive and specific biomarkers such as uAGT, clinicians may be able to identify ADHF patients at high risk of developing AKI as early as on the first day of admission. If confirmed, uAGT levels on the first day of admission may improve clinicians' ability to assess ADHF patients' risk of developing AKI and to predict their 1-year prognosis, which in turn would help clinicians to plan and initiate the most appropriate management strategies during hospitalization and post discharge."
The study will be published in an upcoming issue of the 'Journal of the American Society of Nephrology' (JASN).