Language

English

Publication Date

11-1-2025

Journal

European Journal of Heart Failure

DOI

10.1002/ejhf.70079

PMID

41181870

PMCID

PMC12765416

PubMedCentral® Posted Date

11-3-2025

PubMedCentral® Full Text Version

Post-print

Abstract

Several urinary markers reflect disease severity and have the potential to support the management of heart failure (HF). Collecting urine samples is easy and inexpensive, and urine sample composition can be altered not only by underlying kidney impairments (i.e. filtration barrier damage and tubular injury) but also via neurohormonal and inflammatory activation, ageing, comorbidities, other medical conditions and pharmacological interventions. For instance, urinary sodium may help to predict the response to loop diuretic therapy in acute HF, while albuminuria is used as a risk marker and therapeutic target for the progression of cardiovascular and kidney diseases in chronic HF, especially when accompanied by kidney disease. However, these markers remain underutilized in clinical practice. This review paper underscores the role of urinary markers in HF, with a specific focus on: (i) the pathophysiologic mechanisms underlying urinary marker excretion, (ii) the prognostic values of urinary markers across diverse HF phenotypes and non-cardiovascular comorbidities (i.e. chronic kidney disease and diabetes), (iii) the impact of medical therapies on urinary markers, and (iv) existing knowledge gaps that challenge their implementation in clinical practice. The recommendations are aligned with current guidelines, evidence, and expert consensus.

Keywords

Humans, Heart Failure, Biomarkers, Prognosis, Heart failure, Urinary markers, Chronic kidney disease, Diabetes

Published Open-Access

yes

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