Evidence map›Paper›PMID 41832743›Full record

Trial reportESC heart failure2026

Kidney tubule injury is associated with sodium avidity and diuretic responsiveness in acute heart failure.

Yu Horiuchi, Stephen Duff, Dirk J van Veldhuisen, Michelle M Estrella, Michael G Shlipak, Yoshimitsu Takaoka, Patrick T Murray, Joachim H Ix, Nicholas Wettersten

Abstract readRandomized Controlled TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in ESC heart failure, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Yu HoriuchiDivision of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan.
Stephen DuffSchool of Medicine, University College Dublin, Dublin, Ireland.ORCID 0000-0003-1270-1181
Dirk J van VeldhuisenDepartment of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Michelle M EstrellaNephrology Section, San Francisco Veterans Affairs Healthcare System, San Francisco, CA, USA.
Michael G ShlipakKidney Health Research Collaborative, Department of Medicine, SanFrancisco VA Healthcare System, San Francisco, CA, USA.
Yoshimitsu TakaokaDivision of Cardiovascular Medicine, University of California, San Diego, La Jolla, CA, USA.
Patrick T MurraySchool of Medicine, University College Dublin, Dublin, Ireland.
Joachim H IxDivision of Nephrology-Hypertension, Department of Medicine, University of California San Diego, and Veterans Affairs San Diego Healthcare System, San Diego, CA, USA.
Nicholas WetterstenDivision of Cardiovascular Medicine, University of California, San Diego, La Jolla, CA, USA.ORCID 0000-0002-6122-1152

Funding

CSRD VA IK2 CX002105
6 · The paper itself

Abstract

introductionGreater sodium avidity in acute heart failure (AHF) is associated with worse outcomes, but whether kidney tubule injury is associated with sodium avidity and impaired diuretic responsiveness remains underexplored.

methodsWe evaluated 339 participants from the ROSE-AHF trial, which enrolled patients hospitalized for AHF with kidney dysfunction and randomized them to the dopamine, nesiritide, or placebo group. Urinary kidney injury molecule-1 (KIM-1), N-acetyl-β-D-glucosaminidase (NAG), and neutrophil gelatinase-associated lipocalin (NGAL) were measured at enrolment. Associations between these biomarkers and urinary sodium (uNa) concentration at baseline, fractional excretion of sodium (FeNa), as well as total uNa output and urine output over 72-h were assessed using multivariable regression models.

resultsHigher KIM-1 and NAG values at baseline were associated with lower uNa concentration at baseline [-6.1% (-8.5%, -3.7%), P < 0.001 and -5.9% (-9.2%, -2.6%), P & .001, respectively, per two-fold increase in each biomarker]. Higher baseline KIM-1 and NAG were also associated with lower FeNa [-6.1% (-8.5%, -3.6%), P < .001 and -5.2% (-8.6%, -3.6%), P = 0 .001, respectively, per two-fold increase in each biomarker]. Higher baseline KIM-1 was associated with lower total uNa excretion over 72-h [-3.6% (-6.8%, -0.2%), P = 0.037 per two-fold increase]. None of the biomarkers were associated with urine output over 72-h.

conclusionKidney tubular injury, as assessed by urine KIM-1 and NAG, is associated with greater sodium avidity and higher KIM-1 is associated with impaired diuretic responsiveness in AHF.

Indexed as

DiureticsHeart FailureKidney TubulesSodiumAcute DiseaseAgedBiomarkersFemaleHepatitis A Virus Cellular Receptor 1HumansMaleBiomarkersDiureticsHAVCR1 protein, humanHepatitis A Virus Cellular Receptor 1SodiumAcute heart failureDiuretic resistanceKidney tubule biomarkersNatriuresis

Identifiers

PMID41832743
PMCPMC13037371

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.