Dipstick proteinuria is a prognostic indicator of short-term mortality in patients with heart failure.

Background: Proteinuria is common in patients with acute heart failure (AHF). This study investigated the relationship between proteinuria and short-term mortality among patients hospitalized for AHF at two university hospitals.

Methods: Adult hospitalized patients with AHF were retrospectively studied. Proteinuria was defined based on the first urine dipstick test within 48 h after the AHF diagnosis. The death risk was assessed using an Enhanced Feedback for Effective Cardiac Treatment (EFFECT) 30-day mortality risk score.

Results: Of the 1,058 eligible patients with AHF, 583 (55.1%) exhibited proteinuria. The degree of proteinuria was positively correlated with poor AHF prognostic indicators (C-reactive protein and N-terminal pro-brain natriuretic peptide) and negatively correlated with protective indicators (basal estimated glomerular filtration rate, haemoglobin, and serum albumin). The EFFECT mortality risk score and the in-hospital mortality rate of patients with proteinuria were significantly higher than that of the patients without proteinuria. According to different multivariate logistic regression models, proteinuria increased the risk of in-hospital mortality after correcting for multiple variables, including the EFFECT mortality risk score, diabetes, RASI, NT-proBNP, albumin and chronic kidney disease stages. Compared with the NT-proBNP, proteinuria and degree of proteinuria yielded higher areas under the ROC curve for predicting in-hospital mortality.

Conclusions: Our results demonstrate that proteinuria correlates with the short-term mortality rate of patients hospitalized for AHF. Dipstick proteinuria testing might represent a promising prognostic indicator for these patients.