Clinical Significance of Qualitative Urinalysis in Chronic Heart Failure

Background: Measure of renal function based on blood test is one of important prognostic factors for chronic heart failure (CHF). Qualitative urinalysis can be performed easily and is useful as a screening test for renal disease. However, the clinical significance of qualitative urinalysis in CHF is not well elucidated. Aim: We aimed to investigate the prevalence, prognostic impacts on CHF and the determinants of abnormal qualitative urinalysis. Methods: Consecutive 1190 patients (969 men, mean age 61.0 years) with CHF who underwent echocardiography, blood test and qualitative urinalysis were enrolled. Patients were followed up (median 1155 days) to register cardiac deaths or rehospitalization for worsening of heart failure. Results: 233 (19.6%) patients had abnormal qualitative urinalysis (168 with proteinuria and 100 with hematuria). There were 407 cardiac events (377 rehospitalization due to worsening of heart failure and 30 cardiac deaths) during the follow-up periods. Cox proportional hazard analyses after adjusting for several confounding factors including estimated glomerular filtration rate (eGFR), the abnormal qualitative urinalysis was an independent factor to predict adverse clinical outcomes (P = .044). In multivariate logistic analysis, eGFR < 60 ml/min/1.73 m² (P < .001), diabetes mellitus (P = .035) and inferior vena cava diameter (P = .010) were independently associated with the abnormal qualitative urinalysis. Conclusion: Qualitative urinalysis is an important prognostic tool and influenced by venous congestion in CHF.