Urine Test predicts risk of kidney damage in patients with heart failure

Urine Test predicts risk of kidney damage in patients with heart failure

The levels of a protein in the urine can help doctors to predict which patients with acute heart failure are at increased risk of developing a kidney injury during hospitalization.

Levels of urinary angiotensinogen in the time of hospital admission predicted the risk of developing acute renal insufficiency decompensated, with considerable accuracy, and helped them to doctors to predict the risk of patients to return to be hospitalized or die within a year.

Scientists at the Medical University of the South (Guangzhou, China) conducted a study in 436 patients with acute decompensated heart failure (ICAD) to validate a new marker, the urinary angiotensinogen (uAGT), to predict the risk of the patients develop acute kidney disease (IRA).  The main objective was to demonstrate and validate the assumption that the measures of uAGT daily during the first week of hospitalization predict the development of anger and the prognosis for a year of these patients. The specific samples of blood and urine samples were collected immediately after the accession, before any treatment in the hospital, and every 24 hours during the first seven days, during hospitalization.

A kit was used in ELISA assay for the quantification of the AGT in the urine and plasma. We used western blot analysis with a standard goat polyclonal antibody affinity purified by human against AGT, to quantify the uAGT. To compare the predictive performance of the uAGT and markers of kidney damage reported, measured the lipocalin associated with the gelatinase of neutrophils, urinary (NGAL), with an ELISA kit. Creatinine levels were measured using an automatic biochemical analyzer AU 480.

The team demonstrated that uAGT levels at the time of hospital admission predicted the risk of anger with considerable accuracy. The highest quartile of uAGT income was related to a 50 times greater risk of anger, in comparison with the lowest quartile. The level of uAGT, of the patients, at the time of admission also helped the doctors to predict the risk of patients to return to be hospitalized or die after a year.

Fan FanHou, MD, PhD, lead author of the study, said: “Our findings raise the possibility that through the use of sensitive and specific biomarkers as the uAGT, doctors may be able to identify the patients ICAD, who are at high risk to develop anger as soon as the first day of admission. If confirmed, uAGT levels on the first day of income can improve the ability of doctors to assess the risk of the ICAD patients to develop anger and predict the prognosis of a year, which in turn will help doctors to plan and implement the management strategies most appropriate during hospitalization and after discharge”.  The study was published on 26 February 2015, in the Journal of the American Society of Nephrology.

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