ArticleESC heart failure2025
The utility of urine biomarkers in diuretic resistance prediction in heart failure hospitalization.
Article in ESC heart failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
3 citing papers in PubMed.
- Urinary Biomarkers for the Risk Assessment and Management of Heart Failure: Pearls and Pitfalls.Current heart failure reports · 2026Review
- Elevated urinary sodium thresholds in high-salt diet heart failure: implications for diuretic resistance diagnosis.Frontiers in cardiovascular medicine · 2026Article
- The utility of urine biomarkers in diuretic resistance prediction in heart failure hospitalization.ESC heart failure · 2025Article
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Authors and funding
8 authors.
Funding
Abstract
aimsLoop diuretic resistance (LDR) in patients with heart failure hospitalization (HHF) is associated with worse clinical outcomes. The study aimed to assess the predictive ability of urine biomarkers for LDR in HHF.
methodsConsecutive patients with congestive HHF were included. Congestion was defined as the presence of oedema, ascites, or pleural effusion. LDR was defined as persistent congestion on the fourth day of hospitalization despite high intravenous loop diuretic doses. Urine biomarkers [Kidney Injury Molecule-1 (KIM-1), N-acetyl-β-D-glucosaminidase (NAG), uromodulin, glutathione S-transferase Pi (pi-GST) and aquaporin-2], transthoracic echocardiography (TTE), clinical and biochemical parameters on the first and fourth days of hospital stay were evaluated.
resultsForty patients were included. Median age was 84 years (72.8; 86), a median left ventricle ejection fraction (EF) 35.3% (26.5; 49) and a median NT-proBNP 8967.5 pg/mL (3.024; 15.241). LDR was identified in 14 (35%) patients. Univariate analysis identified risk factors for LDR: urine pi-GST concentration on admission and on the fourth day, right ventricle-to-pulmonary circulation coupling index (TAPSE/PASP ratio), serum creatinine and total cholesterol concentrations. Multivariable regression analysis identified that only the urine pi-GST was a significant independent risk factor for LDR. The area under the receiver operating characteristic (ROC) curve (AUC) to predict LDR using urine pi-GST concentration was 0.713 [95% confidence interval (CI), 0.552-0.874; P = 0.009], with 50% sensitivity and 84% specificity.
conclusionsUrine pi-GST concentration may serve as a marker for the development of LDR in patients with HF hospitalization.
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