Heart failure & cardiomyopathies
Utility of Fractional Excretion of Urea Nitrogen in Heart Failure Patients with Chronic Kidney Disease
Authors' conclusion
In HF patients with CKD, FEUN is a potential marker of volume status for risk stratification of post-discharge HF readmission. Low FEUN value (FEUN ≤ 32.1) may represent intravascular dehydration, whereas high FEUN value (FEUN > 38.0) may represent residual congestion; both of them were independent risk factors for HF readmission.
Study context
- Population
- Heart failure (HF) patients with chronic kidney disease (CKD) (discharge eGFR < 60 mL/min/1.73 m²) with fractional excretion of urea nitrogen (FEUN) measured at discharge; median age 80 years, 58% male
- Participants
- 516 patients
- Exposure
- FEUN quartiles at discharge
- Outcome
- Post-discharge HF readmission
- Follow-up
- 3 year
Main finding
As reported in the abstract
HF readmission
- HF readmission rate significantly lower in medium-FEUN than in the other three groups (Kaplan-Meier, log-rank test)
- P = 0.029
Observational data: associations, not effects.
Further findings
Correlation between FEUN and right atrial pressure (right heart catheterization subgroup)
- Significant correlation between FEUN and right atrial pressure
- R = 0.243, P = 0.005
- 130 patients who underwent right heart catheterization
FEUN at discharge and loop diuretics
- FEUN at discharge decreased dose-dependently with loop diuretics (multivariate linear regression)
Original publication
Utility of Fractional Excretion of Urea Nitrogen in Heart Failure Patients with Chronic Kidney Disease. ESC Heart Fail. Published 23 February 2023. doi:10.
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