{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T15:29:58Z","timestamp":1791646198071,"version":"4.3.4"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"16","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,8,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Maintaining euvolemia is crucial for improving prognosis in acute decompensated heart failure (ADHF). Although fractional excretion of urea nitrogen (FEUN) is used as a body fluid volume index in patients with acute kidney injury, the clinical impact of FEUN in patients with ADHF remains unclear. This study aimed to investigate whether FEUN can determine the long\u2010term prognosis in patients with ADHF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      We retrospectively identified 466 patients with ADHF who had FEUN measured at discharge between April 2011 and December 2018. The primary endpoint was post\u2010discharge all\u2010cause death. Patients were divided into two groups according to a FEUN cut\u2010off value of 35%, commonly used in pre\u2010renal failure. The FEUN &lt;35% (low\u2010FEUN) group included 224 patients (48.1%), and the all\u2010cause mortality rate for the total cohort was 37.1%. The log\u2010rank test revealed that the low\u2010FEUN group had a significantly higher rate of all\u2010cause death compared to the FEUN equal to or greater than 35% (high\u2010FEUN) group (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). Multivariate Cox proportional hazards model analysis revealed that low\u2010FEUN was associated with post\u2010discharge all\u2010cause death, independently of other heart failure risk factors (hazard ratio, 1.467; 95% CI, 1.030\u20132.088,\n                      <jats:italic>P<\/jats:italic>\n                      =0.033). The risk of low\u2010FEUN compared to high\u2010FEUN in post\u2010discharge all\u2010cause death was consistent across all subgroups; however, the effects tended to be modified by renal function (threshold: 60\u00a0mL\/min\/1.73\u00a0m\n                      <jats:sup>2<\/jats:sup>\n                      , interaction\n                      <jats:italic>P<\/jats:italic>\n                      =0.069).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Our study suggests that FEUN may be a novel surrogate marker of volume status in patients with ADHF requiring diuretics.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.120.020480","type":"journal-article","created":{"date-parts":[[2021,8,7]],"date-time":"2021-08-07T05:19:56Z","timestamp":1628313596000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Prognostic Value of Fractional Excretion of Urea Nitrogen at Discharge in Acute Decompensated Heart Failure"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0516-8753","authenticated-orcid":false,"given":"Kazutaka","family":"Nogi","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine Nara Medical University Kashihara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2904-4993","authenticated-orcid":false,"given":"Rika","family":"Kawakami","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Nara Medical University Kashihara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoya","family":"Ueda","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Nara Medical University Kashihara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maki","family":"Nogi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Nara Medical University Kashihara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satomi","family":"Ishihara","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Nara Medical University Kashihara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuki","family":"Nakada","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Nara Medical University Kashihara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukihiro","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Nara Medical University Kashihara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Nakagawa","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Nara Medical University Kashihara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7025-0310","authenticated-orcid":false,"given":"Taku","family":"Nishida","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Nara Medical University Kashihara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayako","family":"Seno","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Nara Medical University Kashihara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Onoue","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Nara Medical University Kashihara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsunenari","family":"Soeda","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Nara Medical University Kashihara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Nara Medical University Kashihara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5574-3571","authenticated-orcid":false,"given":"Yoshihiko","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Nara Medical University Kashihara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","first-page":"53","article-title":"Acute decompensated heart failure update","volume":"11","author":"John R","year":"2015","unstructured":"John R, Teerlink KA, Metra M, Rodgers JE. Acute decompensated heart failure update. Current Cardiology Reviews. 2015;11:53\u201362. DOI: 10.2174\/1573403x09666131117174414.","journal-title":"Current Cardiology Reviews"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.933275"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hft110"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.05.027"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e31829e8776"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2018.07.019"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2003.07.031"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2007.04.008"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-12-0994"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.114.001174"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2007.07.001"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.2002.00683.x"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.10330818"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1159\/000254387"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1159\/000168417"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(93)90455-A"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/4907024"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02089953"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1586\/erc.09.74"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199108013250501"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw128"},{"key":"e_1_3_1_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/00041552-200409000-00008"},{"key":"e_1_3_1_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.semnephrol.2009.03.008"},{"key":"e_1_3_1_25_2","first-page":"F823","article-title":"Vasopressin effects on urea and h2o transport in inner medullary collecting duct subsegments","volume":"253","author":"Sands JM","year":"1987","unstructured":"Sands JM, Nonoguchi H, Knepper MA. Vasopressin effects on urea and h2o transport in inner medullary collecting duct subsegments. Am J Physiol. 1987;253:F823\u2013832. DOI: 10.1152\/ajprenal.1987.253.5.F823.","journal-title":"Am J Physiol"},{"key":"e_1_3_1_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.04.044"},{"key":"e_1_3_1_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2006.08.034"},{"key":"e_1_3_1_28_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.765289"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.120.020480","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T07:04:25Z","timestamp":1715583865000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.120.020480"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,17]]},"references-count":27,"journal-issue":{"issue":"16","published-print":{"date-parts":[[2021,8,17]]}},"alternative-id":["10.1161\/JAHA.120.020480"],"URL":"https:\/\/doi.org\/10.1161\/jaha.120.020480","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,17]]},"assertion":[{"value":"2020-12-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-28","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-07","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e020480"}}