{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T10:59:53Z","timestamp":1785149993224,"version":"3.55.0"},"reference-count":29,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T00:00:00Z","timestamp":1784937600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background: Albuminuria is a marker of cardiovascular and renal risk and may reflect dynamic haemodynamic changes in acute heart failure (AHF). However, the prognostic value of early urine albumin-to-creatinine ratio (UACR) monitoring during the vulnerable post-discharge phase remains unclear. Methods: We conducted a prospective single-centre study, including 88 patients with hospitalization for AHF. UACR was measured at discharge and at a two-week follow-up visit. Patients were stratified according to UACR trajectory: (1) persistent normoalbuminuria; (2) microalbuminuria with significant reduction (&gt;50%) or normalization; and (3) persistent microalbuminuria without significant reduction or macroalbuminuria. Clinical outcomes included HF readmissions, all-cause mortality and a composite endpoint of HF readmission or all-cause mortality. Results: Albuminuria was prevalent in 64.8% of patients. Group 3 showed a higher burden of comorbidities, worse renal function and higher congestion markers. During a median follow-up of 553 days, group 3 had a higher incidence of HF events and the composite endpoint. In multivariable analysis, group 3 was independently associated with HF hospitalization (HR 3.09, 95% CI 1.19\u20138.04; p = 0.021) and the composite endpoint (HR 3.31, 95% CI 1.18\u20139.35; p = 0.024), whereas no independent association was observed for group 2. Renal function remained stable in groups 1 and 2, while group 3 showed worse renal outcomes. Conclusions: Albuminuria is frequently observed during AHF and is closely related to haemodynamic congestion. Persistent albuminuria identifies a high-risk phenotype, whereas early reduction was associated with more favourable unadjusted outcomes. Early post-discharge UACR trajectory may improve risk stratification during the vulnerable phase.<\/jats:p>","DOI":"10.3390\/jcm15155825","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T09:47:41Z","timestamp":1785145661000},"page":"5825","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early Post-Discharge Albuminuria Trajectory and Clinical Outcomes After Acute Heart Failure"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7817-5850","authenticated-orcid":false,"given":"Mario","family":"Galv\u00e1n-Ruiz","sequence":"first","affiliation":[{"name":"Cardiology Department, Hospital Universitario de Gran Canaria Doctor Negr\u00edn, 35016 Las Palmas de Gran Canaria, Spain"},{"name":"Health Sciences Faculty, Universidad de Las Palmas de Gran Canaria (ULPGC), 35016 Las Palmas de Gran Canaria, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Nogueira-Salgueiro","sequence":"additional","affiliation":[{"name":"Clinical Analysis Department, Hospital Universitario de Gran Canaria Doctor Negr\u00edn, 35010 Las Palmas de Gran Canaria, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"D\u00e9niz-Rosario","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Universitario de Gran Canaria Doctor Negr\u00edn, 35016 Las Palmas de Gran Canaria, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2631-6230","authenticated-orcid":false,"given":"Mar\u00eda del Val","family":"Groba-Marco","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Universitario de Gran Canaria Doctor Negr\u00edn, 35016 Las Palmas de Gran Canaria, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6116-2579","authenticated-orcid":false,"given":"Miguel","family":"Fern\u00e1ndez-de-Sanmamed-Gir\u00f3n","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Universitario de Gran Canaria Doctor Negr\u00edn, 35016 Las Palmas de Gran Canaria, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6816-4157","authenticated-orcid":false,"given":"Jes\u00fas Mar\u00eda","family":"Gonz\u00e1lez-Mart\u00edn","sequence":"additional","affiliation":[{"name":"Research Unit, Hospital Universitario de Gran Canaria Doctor Negr\u00edn, 35010 Las Palmas de Gran Canaria, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daesub","family":"Chung-Kwon","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Universitario de Gran Canaria Doctor Negr\u00edn, 35016 Las Palmas de Gran Canaria, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bel\u00e9n","family":"Rojas-Escriv\u00e1","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Universitario de Gran Canaria Doctor Negr\u00edn, 35016 Las Palmas de Gran Canaria, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco Antonio","family":"Suarez-Ben\u00edtez","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Universitario de Gran Canaria Doctor Negr\u00edn, 35016 Las Palmas de Gran Canaria, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elvira","family":"Mart\u00edn-Bou","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Universitario de Gran Canaria Doctor Negr\u00edn, 35016 Las Palmas de Gran Canaria, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Aladro-Escribano","sequence":"additional","affiliation":[{"name":"Nephrology Department, Complejo Hospitalario Universitario Insular, 35010 Las Palmas de Gran Canaria, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4729-3993","authenticated-orcid":false,"given":"Juan Carlos","family":"Quevedo-Reina","sequence":"additional","affiliation":[{"name":"Nephrology Department, Hospital Universitario de Gran Canaria Doctor Negr\u00edn, 35010 Las Palmas de Gran Canaria, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Casimira","family":"Dom\u00ednguez-Cabrera","sequence":"additional","affiliation":[{"name":"Clinical Analysis Department, Hospital Universitario de Gran Canaria Doctor Negr\u00edn, 35010 Las Palmas de Gran Canaria, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Burgos-Ram\u00edrez","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Universitario de Gran Canaria Doctor Negr\u00edn, 35016 Las Palmas de Gran Canaria, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Garc\u00eda-Quintana","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Universitario de Gran Canaria Doctor Negr\u00edn, 35016 Las Palmas de Gran Canaria, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2540-3880","authenticated-orcid":false,"given":"Alicia","family":"Conde-Martel","sequence":"additional","affiliation":[{"name":"Health Sciences Faculty, Universidad de Las Palmas de Gran Canaria (ULPGC), 35016 Las Palmas de Gran Canaria, Spain"},{"name":"Internal Medicine Department, Hospital Universitario de Gran Canaria Doctor Negr\u00edn, 35010 Las Palmas de Gran Canaria, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2148","DOI":"10.1093\/eurheartj\/ehaf167","article-title":"Cardiovascular disease in chronic kidney disease","volume":"46","author":"Cherney","year":"2025","journal-title":"Eur. 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