Role of Fractional Excretion of Uric Acid as a Predictor of Cardio-renal Syndrome in Acute Decompensated Heart Failure Patients: An Observational Study
Abstract Body (Do not enter title and authors here): Cardio-renal syndrome (CRS) is a growing health, economical, and societal problem.The diagnosis and treatment of patients with acute decompensated heart failure (ADHF) especially complicated with CRS are challenging and hence, we aimed to determine the prevalence of CRS in ADHF patients and also determine the role of fractional excretion of uric acid (FeUa) in prediction of CRS in patients with ADHF. Methods In this hospital-based, observational study, a total of sixty-five patients with ADHF and who met the inclusion criteria were recruited and their demographic details were recorded. Blood samples were collected, and various laboratory parameters were measured at day-1, day-3, and day-7. The fractional excretion of sodium (FeNa) and FeUa were calculated. Results The mean age of participants was 52.32 ± 14.04 years, and 67.69 % were males. The prevalence of CRS in ADHF patients was noted to be 18.46 %. At baseline, the B-type natriuretic peptide (BNP) level for the enrolled patients was observed to be 8690.06 ± 6181.32 pg/ml. The serum creatinine and serum uric acid elevated as the day of hospitalization increased, and the maximum was observed at day-7 i.e., 1.35 ± 0.54 mg/ml and 11.08 ± 15.83 mg/ml, respectively. Declining trend in the FeNa (%) was noted, and the values at day-1, at day-3, and at day-7 were 1.25 ± 1.18, 1.01 ± 1.08, and 0.80 ± 0.79, respectively. The FeUa (%) value increased at day-3 from 5.60 ± 7.47 to 6.95 ± 7.43. However, decrease FeUa value was observed at day-7 (5.78 ± 5.63 %). On receiver operative curve analysis, FeUa served to be a negative predictor of CRS in ADHF patients with an area under the curve of 0.489. Conclusion The FeUa seems to be a negative predictor of CRS in patients hospitalized with ADHF. However, multi-parametric techniques and biomarkers which are available for investigating cardiovascular diseases and kidney diseases may offer opportunities for the evaluation of CRS.
Kunal, Shekhar
( ESIC Medical College Faridabad
, Faridabad
, Haryana
, India
)
Shah, Bhushan
( AIIMS Bhopal
, Bhopal
, India
)
Kathuria, Sanjeev
( GIPMER
, Delhi
, India
)
Kumar, Sunil
( GIPMER
, Delhi
, India
)
Author Disclosures:
Shekhar Kunal:DO NOT have relevant financial relationships
| Bhushan Shah:DO NOT have relevant financial relationships
| sanjeev kathuria:No Answer
| SUNIL KUMAR:No Answer