Heart failure & cardiomyopathiesSecondary analysis
Kidney tubule injury is associated with sodium avidity and diuretic responsiveness in acute heart failure
- secondary analysis of the ROSE-AHF trial
Authors' conclusion
Kidney 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.
Study context
- Population
- Patients hospitalized for acute heart failure (AHF) with kidney dysfunction, randomized to dopamine, nesiritide or placebo in the ROSE-AHF trialparticipants evaluated from the ROSE-AHF trial
- Participants
- 339 patients
- Comparison
- Associations of urinary KIM-1, NAG and neutrophil gelatinase-associated lipocalin (NGAL) at enrolment with uNa concentration at baseline, FeNa, total uNa output and urine output over 72-h
Primary result
As reported in the abstract
uNa concentration at baseline, per two-fold increase in biomarker · baseline
% difference (CI)P value
KIM-1 (per two-fold increase)lower uNa concentration with higher KIM-1
−6.1%(−8.5% to −3.7%)
P < 0.001NAG (per two-fold increase)lower uNa concentration with higher NAG
−5.9%(−9.2% to −2.6%)
P & .001Per two-fold increase, as printed
Further findings
| Outcome | % difference (CI) | P value | |
|---|---|---|---|
| FeNa, per two-fold increase in biomarker — KIM-1 (per two-fold increase) · lower FeNa with higher KIM-1 | −6.1% (−8.5% to −3.6%) | P < 0.001 | |
| FeNa, per two-fold increase in biomarker — NAG (per two-fold increase) · lower FeNa with higher NAG | −5.2% (−8.6% to −3.6%) | P = 0 .001 | |
| Total uNa excretion over 72-h, per two-fold increase in KIM-1 · lower total uNa excretion with higher KIM-1 | −3.6% (−6.8% to −0.2%) | P = 0.037 | |
| −10−505Difference (linear scale) |
Urine output over 72-h
- None of the biomarkers were associated with urine output over 72-h
Original publication
Kidney tubule injury is associated with sodium avidity and diuretic responsiveness in acute heart failure. ESC Heart Fail. Published 13 March 2026. doi:10.1093/eschf/xvag079
Summarised from the published abstract; every number is checked against it