Generalizability of the Spectrum of Kidney Risk in the FINEARTS-HF Trial to U.S. Adults With Heart Failure
John W. Ostrominski, Rahul Aggarwal, Brian Claggett, Ian J. Kulac, Akshay S. Desai, Pardeep S. Jhund, Carolyn S.P. Lam, Bertram Pitt, Michele Senni, Sanjiv J. Shah, Adriaan A. Voors, Faı̈ez Zannad, James Lay‐Flurrie, Prabhakar Viswanathan, John J.V. McMurray, Scott D. Solomon, Muthiah Vaduganathan
Abstract
Albuminuria (urine albumin-to-creatinine ratio [UACR] ≥30 mg/g) and estimated glomerular filtration rate (eGFR) constitute the basis of contemporary kidney disease staging, and are independently associated with HF onset and progression. 1 ME Grams Coresh J Matsushita K et al. Writing Group for the CKD Prognosis ConsortiumEstimated Glomerular Filtration Rate, Albuminuria, and Adverse Outcomes: An Individual-Participant Data Meta-Analysis. JAMA. 2023; 330: 1266-1277 Crossref Scopus (15) Google Scholar , 2 Stevens PE Ahmed SB Carrero JJ et al. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work GroupKDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int. 2024; 105: S117-S314 Scopus (11) Google Scholar , 3 Butler J Packer M Siddiqi TJ et al. Efficacy of Empagliflozin in Patients With Heart Failure Across Kidney Risk Categories. J Am Coll Cardiol. 2023; 81: 1902-1914 Crossref Scopus (9) Google Scholar , 4 Khan MS Shahid I Anker SD et al. Albuminuria and Heart Failure: JACC State-of-the-Art Review. J Am Coll Cardiol. 2023; 81: 270-282 Crossref PubMed Scopus (19) Google Scholar As such, assessment of these complementary domains is important in clinical and research efforts involving the HF population. However, because UACR has been infrequently assessed in HF outcomes trials, generalizability of trial-level kidney risk to real-world HF populations remains uncertain.