#AI reads Urine# Urine Tubular Biomarkers Are Associated With Natriuresis in Patients With Acute Heart Failure
Published 03 February, 2026
This study focuses on patients with acute heart failure, exploring the association between renal tubular biomarkers in their urine and sodium excretion efficacy after diuretic administration. The core finding is that the health status of the kidneys' renal tubules influences the effectiveness of diuretics in helping patients excrete sodium and reduce edema, with relevant biomarkers capable of reflecting the condition of the renal tubules. The study enrolled 418 patients who received intravenous diuretics, measuring 14 types of renal tubular biomarkers and urine sodium concentration (a direct indicator of sodium excretion) in their urine post-medication. It was discovered that six key biomarkers exhibit a notable correlation: the higher their concentrations, the lower the urine sodium concentration, indicating reduced sodium excretion and poorer diuretic efficacy. This association holds true regardless of whether patients have concurrent acute kidney injury and remains significant even when accounting for factors such as age, gender, renal function (e.g., estimated glomerular filtration rate), and diuretic dosage. Additionally, patients with higher urine sodium concentrations have a lower risk of death or readmission due to heart failure within one year, reaffirming the crucial role of adequate sodium excretion in patient prognosis. The significance of this research lies in its potential to predict diuretic response in acute heart failure patients through the detection of these biomarkers, enabling timely adjustments to treatment plans (such as switching diuretics or modifying dosages). Furthermore, it highlights that renal tubular health, an previously overlooked factor, plays an important role in diuretic efficacy, offering a new direction for future studies on the causes and solutions of diuretic resistance.
J Am Heart Assoc. 2025 Dec 11:e044812. doi: 10.1161/JAHA.125.044812.
Youhe Gao
Statement: During the preparation of this work the author(s) used Doubao / AI reading for summarizing the content. After using this tool/service, the author(s) reviewed and edited the content as needed and take(s) full responsibility for the content of the published article.
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