Significance of bacteriuria and leukocyturia in the outpatients with heart failure

A. Kucukbayrak 1, T. Tas 2, E. Kemahli 3, S.S. Ayhan 4, S. Ozturk 4, M.F. Ozlu 4, A. Erdem 4, M. Yazici 4, H. Akdeniz 1

1 Department of Infectious Diseases and Clinical Microbiology, Izzet Baysal Medical Faculty, Bolu (Turkey)

2 Department of Medical Microbiology, Izzet Baysal Medical Faculty, Bolu (Turkey)

3 Department of Urology, Izzet Baysal Medical Faculty, Bolu (Turkey)

4 Department of Cardiology, Izzet Baysal Medical Faculty, Bolu (Turkey)

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• Cardiology

AIM: To investigate the relationship between severity of illness and hospitalization with the presence of leukocyturia and bacteriuria in outpatients with heart failure (HF).

PATIENTS AND METHODS: Four hundred three patients admitted with the diagnosis of HF to cardiology outpatient clinic were included in this study. According to New York Heart Association (NYHA) classification, the patients were divided into two groups to be group A (decompensated) as stage 3 or 4 and group B as stage 1 or 2 (compensated HF). All subjects underwent standard 12-lead ECG and echocardiography. In all patients, full blood, biochemical tests as liver and kidney function tests, full urinary analysis (FUA) and thyroid function tests were analyzed. Mid-stream urine for culture was taken for the leukocytes number ≥ 5 mm³.

RESULTS: The mean leukocyte number (MLN) in urine of patients was 16.56 ± 13.63 in Group A and was 3.74 ± 5.31 in Group B (p < 0.000). The moderately positive correlation was found between the MLN and NHYA class in all patients (r = 0.526; p < 0.000). In receiver operating characteristic (ROC) curve analysis, the optimal cut-off value of leukocytes in urinalysis to predict hospitalization of CHF was ≥ 5, with 76.1% sensitivity and 75.7% specificity (area under the curve 0.825, 95% confidence interval 0.781 to 0.862, p = 0.000).

CONCLUSIONS: We found that the numbers of leukocytes in urinalysis of hospitalized patients with HF were significantly higher than non-hospitalized persons. Also, number of leukocyte in urinalysis was positively correlated with NYHA class of HF patients. Namely, leukocyturia may be an indicator of decompensations in HF patients.

Corresponding Author: Abdulkadir Kucukbayrak, MD; e-mail: abdulbayrak@yahoo.com

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