Now, a simple urine test can predict heart disease and treat it early
A latest study has found that people with consistently high levels of urinary albumin excretion (UAE) and serum creatinine were at a higher risk of developing heart failure. A simple diagnostic test can help cardiologists develop a preventive protocol, says Dr Nishith Chandra, Principal Director, Interventional Cardiology, Fortis Escorts Heart Institute, Delhi
Usually heart failure, or congestive heart failure, develops when your heart cannot pump enough blood that is required for your body’s needs and is a consequence of a long-time stress on the heart caused by either prolonged hypertension, diabetes or a stiffening of the heart walls. But since it happens over time you may not know a tipping point. Now latest research in The European Journal of Heart Failure has shown that a urine test and its deranged markers may help detect potential heart failure in high-risk patients and resort to preventive methods early enough. The findings are not exactly new but because the study involved a large sample size, it establishes the validity of a urine test to detect heart disease early.
WHAT ARE URINE MARKERS?
The study found that people with consistently high levels of urinary albumin excretion (UAE) and serum creatinine were at a higher risk of developing heart failure. All that the
researchers analysed were urine-sample data from nearly 7,000 Dutch participants between 28 and 75 years of age over 11 years. Those with elevated levels of only UAE had an increased risk of dying from all causes.
This also establishes the link between kidney dysfunction and heart failure. Healthy kidneys help maintain a healthy balance of chemicals in the blood. Part of their role in filtering the bloodstream is to ensure that albumin, the most common large-sized protein circulating in your system, does not enter your urine. It is common for tiny sodium or glucose molecules to be present in the urine but not albumin. So if this is present in the urine, it means that the kidney is not functioning properly and its filtration system has been breached. Serum creatinine means the kidneys are unable to flush out waste. Both of these indicate a cardio-renal syndrome, whereby a chronic problem in the heart or kidneys could affect the dependent organ equally. So if the heart is unable to pump enough blood, then the kidney functioning gets affected, or if there is kidney damage, then it impacts the heart. That’s why the albumin-creatinine ratio becomes important to ensure both organs are treated early enough.
The urine albumin‐to‐creatinine ratio (UACR) should be below 30 mg/g. The normal UACR value is less than or equal to 17 mg/g in men but in women, the level is observed to be higher, ranging around 25 mg/g. A ratio less than 30 mg/g is considered mild, 39 to 300 mg/g poses a moderate risk to the heart and more than 300 mg/g indicates a serious threat to the heart.
HOW ARE KIDNEY AND HEART FUNCTIONS RELATED?
Both the heart and kidney can have individual problems and impact the other organ. But sometimes both can have separate problems. A heart attack or failure may decrease the blood supply to the kidney, putting pressure on it. But the moment the heart improves, the kidney follows suit. Sometimes kidney diseases, like Chronic Kidney Disease (CKD), overwork the heart as it needs to pump harder to get the blood to help the diseased kidneys. This elevates blood pressure (BP) and can cause heart disease. CKD can also accelerate atherosclerosis or plaque deposition in the heart arteries. That’s why cardiologists check creatinine if you are diagnosed with blood pressure and hypertension rather early. This is done to ascertain the exact cause of your blood pressure as drugs given to lower it, when you have kidney dysfunction, can impair kidney functioning further. You may be given another kind of blood pressure medicine that can help decrease or stop you from losing albumin in your urine. Even if you have normal blood pressure, you may still be told to take one of these types of medicine besides being advised a low salt, sodium meal.
Now cardiologists can recommend the urine test to measure the urine albumin and creatinine ratio and assess where your heart and kidney stand, and advise corrective steps and medication.