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Current Heart Failure Reports

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01-12-2019 | Acute Kidney Injury | Biomarkers of Heart Failure (WH Tang & J Grodin, Section Editors)

Utility of Urine Biomarkers and Electrolytes for the Management of Heart Failure

Author: Frederik Hendrik Verbrugge

Published in: Current Heart Failure Reports | Issue 6/2019

Abstract

Purpose of Review

To provide insight into the role of urine biomarkers and electrolytes for the management of heart failure.

Recent Findings

The age-dependent decrease in glomerular filtration rate due to loss of functional nephrons occurs at a faster pace in heart failure, potentially exacerbated by episodes of acute kidney injury. Urine biomarkers have not convincingly demonstrated to improve detection of irreversible renal damage and predict long-term renal trajectories, compared with serial creatinine measurements. Recent data show that natriuresis and diuretic response track poorly with glomerular filtration, but strongly with prognosis. Urine sodium concentration > 50–70 mmol/L was recently put forward through expert consensus as an adequate diuretic response.

Summary

The value of urine biomarkers to detect structural renal damage in heart failure remains unsure and the latter is probably uncommon, especially over short-term follow-up. Urine electrolytes on the other hand predict diuretic response accurately and may allow better diuretic titration.

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Title: Utility of Urine Biomarkers and Electrolytes for the Management of Heart Failure
Author: Frederik Hendrik Verbrugge
Publication date: 01-12-2019
Publisher: Springer US
Keywords: Acute Kidney Injury
Diuretics
Heart Failure
Acute Heart Failure
Acute Kidney Injury
Biomarkers
Published in: Current Heart Failure Reports / Issue 6/2019
Print ISSN: 1546-9530
Electronic ISSN: 1546-9549
DOI: https://doi.org/10.1007/s11897-019-00444-z

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Illustration of figure on mountain summit/© Orapun / Stock.adobe.com, STEP AAG HeroTeaserCollection image/© Tarek / Generated with AI / Stock.adobe.com, ACC 2024 Pediatric and Congenital Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Pulmonary Vascular Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Valvular Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 HF and Cardiomyopathies: Year in Review/© 2024 American College of Cardiology, Woman out walking/© Seventyfour / stock.adobe.com (symbolic image with model), Woman checking smartwatch /© saltdium / stock.adobe.com (symbolic image with model), Cardiac catheterization/© Damian / stock.adobe.com

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose of Review

Recent Findings

Summary

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Other articles of this Issue 6/2019

Role of Palliative Care in the Outpatient Management of the Chronic Heart Failure Patient

The Approach to the Psychosocial Evaluation of Cardiac Transplant and Mechanical Circulatory Support Candidates

Right Ventricular Strain to Assess Early Right Heart Failure in the Left Ventricular Assist Device Candidate

Synthesizing Markers of Kidney Injury in Acute Decompensated Heart Failure: Should We Even Keep Looking?

Patient-Associated Predictors of 15- and 30-Day Readmission After Hospitalization for Acute Heart Failure

Targeting Natriuretic Peptide Levels in Heart Failure with Therapy: Does “X” Really Mark the Spot?

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