Back to Search
Start Over
Clinical importance of urinary sodium excretion in acute heart failure.
- Source :
- European Journal of Heart Failure; Aug2020, Vol. 22 Issue 8, p1438-1447, 10p, 4 Charts, 4 Graphs
- Publication Year :
- 2020
-
Abstract
- <bold>Aims: </bold>Urinary sodium assessment has recently been proposed as a target for loop diuretic therapy in acute heart failure (AHF). We aimed to investigate the time course, clinical correlates and prognostic importance of urinary sodium excretion in AHF.<bold>Methods and Results: </bold>In a prospective cohort of 175 consecutive patients with an admission for AHF we evaluated urinary sodium excretion 6 h after initiation of loop diuretic therapy. Clinical outcome was all-cause mortality or heart failure rehospitalization. Mean age was 71 ± 14 years, and 44% were female. Median urinary sodium excretion was 130 (67-229) mmol at 6 h, 347 (211-526) mmol at 24 h, and decreased from day 2 to day 4. Lower urinary sodium excretion was independently associated with male gender, younger age, renal dysfunction and pre-admission loop diuretic use. There was a strong association between urinary sodium excretion at 6 h and 24 h urine volume (beta = 0.702, P < 0.001). Urinary sodium excretion after 6 h was a strong predictor of all-cause mortality after a median follow-up of 257 days (hazard ratio 3.81, 95% confidence interval 1.92-7.57; P < 0.001 for the lowest vs. the highest tertile of urinary sodium excretion) independent of established risk factors and urinary volume. Urinary sodium excretion was not associated with heart failure rehospitalization.<bold>Conclusion: </bold>In a modern, unselected, contemporary AHF population, low urinary sodium excretion during the first 6 h after initiation of loop diuretic therapy is associated with lower urine output in the first day and independently associated with all-cause mortality. [ABSTRACT FROM AUTHOR]
- Subjects :
- HEART failure
EXCRETION
HOSPITAL admission & discharge
PATIENT readmissions
Subjects
Details
- Language :
- English
- ISSN :
- 13889842
- Volume :
- 22
- Issue :
- 8
- Database :
- Complementary Index
- Journal :
- European Journal of Heart Failure
- Publication Type :
- Academic Journal
- Accession number :
- 145967661
- Full Text :
- https://doi.org/10.1002/ejhf.1753