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Clinical importance of urinary sodium excretion in acute heart failure

AIMS: 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. METHODS AND RESULTS: In a prospective cohort of 17...

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Autores principales: Damman, Kevin, Ter Maaten, Jozine M., Coster, Jenifer E., Krikken, Jan A., van Deursen, Vincent M., Krijnen, Hidde K., Hofman, Mischa, Nieuwland, Wybe, van Veldhuisen, Dirk J., Voors, Adriaan A., van der Meer, Peter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Ltd. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7540361/
https://www.ncbi.nlm.nih.gov/pubmed/32086996
http://dx.doi.org/10.1002/ejhf.1753
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author Damman, Kevin
Ter Maaten, Jozine M.
Coster, Jenifer E.
Krikken, Jan A.
van Deursen, Vincent M.
Krijnen, Hidde K.
Hofman, Mischa
Nieuwland, Wybe
van Veldhuisen, Dirk J.
Voors, Adriaan A.
van der Meer, Peter
author_facet Damman, Kevin
Ter Maaten, Jozine M.
Coster, Jenifer E.
Krikken, Jan A.
van Deursen, Vincent M.
Krijnen, Hidde K.
Hofman, Mischa
Nieuwland, Wybe
van Veldhuisen, Dirk J.
Voors, Adriaan A.
van der Meer, Peter
author_sort Damman, Kevin
collection PubMed
description AIMS: 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. METHODS AND RESULTS: 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. CONCLUSION: 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.
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spelling pubmed-75403612020-10-09 Clinical importance of urinary sodium excretion in acute heart failure Damman, Kevin Ter Maaten, Jozine M. Coster, Jenifer E. Krikken, Jan A. van Deursen, Vincent M. Krijnen, Hidde K. Hofman, Mischa Nieuwland, Wybe van Veldhuisen, Dirk J. Voors, Adriaan A. van der Meer, Peter Eur J Heart Fail TREATMENT AIMS: 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. METHODS AND RESULTS: 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. CONCLUSION: 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. John Wiley & Sons, Ltd. 2020-02-22 2020-08 /pmc/articles/PMC7540361/ /pubmed/32086996 http://dx.doi.org/10.1002/ejhf.1753 Text en © 2020 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle TREATMENT
Damman, Kevin
Ter Maaten, Jozine M.
Coster, Jenifer E.
Krikken, Jan A.
van Deursen, Vincent M.
Krijnen, Hidde K.
Hofman, Mischa
Nieuwland, Wybe
van Veldhuisen, Dirk J.
Voors, Adriaan A.
van der Meer, Peter
Clinical importance of urinary sodium excretion in acute heart failure
title Clinical importance of urinary sodium excretion in acute heart failure
title_full Clinical importance of urinary sodium excretion in acute heart failure
title_fullStr Clinical importance of urinary sodium excretion in acute heart failure
title_full_unstemmed Clinical importance of urinary sodium excretion in acute heart failure
title_short Clinical importance of urinary sodium excretion in acute heart failure
title_sort clinical importance of urinary sodium excretion in acute heart failure
topic TREATMENT
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7540361/
https://www.ncbi.nlm.nih.gov/pubmed/32086996
http://dx.doi.org/10.1002/ejhf.1753
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