The relationship between albuminuria and poor clinical outcomes in patients with infective endocarditis

Abstract

Background: We explored the impact of albuminuria on clinical outcomes in patients with infective endocarditis (IE).

Methods: Patients with IE were prospectively enrolled and divided into 3 groups based on albuminuria measured by qualitative dipstick at admission and were followed up for 1y. Univariate and multivariate analysis were performed to evaluate the relationship between albuminuria and mortality.

Results: Nine-hundred seventy patients were divided into 3 groups: negative (urine dipstick negative) (n=694), trace (urine dipstick trace) (n=150) and positive (urine dipstick≥1+ protein) (n=126). In-hospital mortality increased with increasing albuminuria (5.2%, 8.0% and 17.5%, p<0.001, for the negative, trace, and positive groups, respectively). Compared with negativity for albuminuria, positivity for albuminuria was an independent risk predictor for in-hospital death (OR=2.79, 95% CI=1.41-5.49; p=0.003). The cumulative rate of one-year mortality was higher among albuminuria-positive patients than among albuminuria-negative patients. Multivariate Cox analysis demonstrated that albuminuria positivity was associated with one-year mortality (HR=1.89, 95% CI=1.17-3.04, p=0.010).

Conclusion: Albuminuria was independently associated with in-hospital death in IE patients. Urine dipstick≥1+ protein was linked to increased one-year mortality. As a simple and inexpensive marker, albuminuria measured by qualitative dipstick might be helpful for risk stratification in IE.

Keywords: Albuminuria; Infective endocarditis; Outcome.