Heart failure & cardiomyopathies
Spot Urine Sodium-to-Creatinine Ratio Surpasses Sodium in Identifying Poor Diuretic Response in Acute Heart Failure
Authors' conclusion
The UNa+/UCr ratio in a spot urine sample 2 h after intravenous diuretic administration is a simple, highly predictive marker for the identification of AHF patients with poor diuretic response, surpassing guidelines-recommended markers like UNa+.
Study context
- Population
- Acute heart failure (AHF) patients with signs of congestion requiring IV diuretics; standardized IV furosemide 1 mg/kg, spot urine at 2 h18 (16%) poor responders
- Participants
- 111 patients
- Comparison
- Spot urine UNa+/UCr ratio vs UNa+ for predicting poor diuretic response
- Outcome
- Poor diuretic response (cumulative urine output <600 ml)
- Follow-up
- First 6 h
Methodological detailssingle-centre
- Single-centre
Performance
As reported in the abstract
Prediction of poor diuretic response · spot urine 2 h post-administration
| Strategy | AUC | Sensitivity | Specificity |
|---|---|---|---|
| UNa+/UCr | 0.956 (95% CI 0.915-0.997), P < 0.001 | — not stated in the abstract | — not stated in the abstract |
| UNa+ | — not stated in the abstract | 0.83 | 0.97 |
AUC
UNa+/UCr0.956 (95% CI 0.915-0.997), P < 0.001
UNa+— not stated in the abstract
Sensitivity
UNa+/UCr— not stated in the abstract
UNa+0.83
Specificity
UNa+/UCr— not stated in the abstract
UNa+0.97
— not stated in the abstract
Further findings
Mean 6 h cumulative diuresis, poor vs good responders
- Mean 6 h cumulative diuresis, poor vs good responders: P < 0.005
Original publication
Spot Urine Sodium-to-Creatinine Ratio Surpasses Sodium in Identifying Poor Diuretic Response in Acute Heart Failure. ESC Heart Fail. Published 10 June 2024. doi:10.
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