AUTHOR=Liang Wei , Liu Qian , Wang Qiong-ying , Yu Heng , Yu Jing 

TITLE=Albuminuria and Dipstick Proteinuria for Predicting Mortality in Heart Failure: A Systematic Review and Meta-Analysis

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 8 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2021.665831

DOI=10.3389/fcvm.2021.665831

ISSN=2297-055X

ABSTRACT=Background: The current study aimed to quantitively assess the prognostic utility of albuminuria as well as dip-stick proteinuria in predicting mortality in heart failure patients.
Methods: PubMed, Embase, ScienceDirect, CENTRAL, and Google Scholar databases were searched up to 10th October 2020. All studies reporting multivariable-adjusted hazard ratios (HR) for albuminuria or dipstick proteinuria for mortality and/or hospitalization in heart failure patients were included. 
Results: Eleven studies were included. Seven assessed albuminuria and five assessed dipstick proteinuria. Our analysis revealed a statistically significant increased risk of all-cause mortality with microalbuminuria (HR: 1.54 95% CI 1.23, 1.93 I2= 79% p=0.0002) and macroalbuminuria (HR: 1.76 95% CI 1.21, 2.56 I2= 88% p=0.003) in heart failure patients. The risk of all-cause mortality and hospitalization was also significantly increased with macroalbuminuria. Microalbuminuria was associated with significantly increased cardiovascular mortality and combined cardiovascular mortality and hospitalization. Positive dipstick test for proteinuria was significantly associated with mortality in heart failure (HR: 1.54 95% CI 1.28, 1.84 I2=67% p<0.00001).
Conclusion: Both microalbuminuria and macroalbuminuria are predictors of mortality in patients with heart failure. Dipstick proteinuria may be used as a rapid screening test to predict mortality in these patients.