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

•This study with relative large sample size shown the strong relationship between albuminuria and poor outcomes in IE.•It was the first to prove that albuminuria was independently related to in-hospital and one-year mortality in IE patients.•Albuminuria measured by qualitative dipstick could be a simple and inexpensive marker for risk stratification.

BackgroundWe explored the impact of albuminuria on clinical outcomes in patients with infective endocarditis (IE).MethodsPatients with IE were prospectively enrolled and divided into 3 groups based on albuminuria measured by qualitative dipstick at admission and were followed up for 1 y. Univariate and multivariate analysis were performed to evaluate the relationship between albuminuria and mortality.ResultsNine-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).ConclusionAlbuminuria 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.