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  3. Early Spot Urinary Sodium and Diuretic Efficiency in Acute Heart Failure and Concomitant Renal Dysfunction.

Early Spot Urinary Sodium and Diuretic Efficiency in Acute Heart Failure and Concomitant Renal Dysfunction.

Fecha de publicación: Fecha Ahead of Print:

Autores de INCLIVA

Participantes ajenos a INCLIVA

  • Llacer, Pau
  • Sanchis, Ignacio
  • Ventura, Silvia
  • Sanchez, Ruth
  • Bayes-Genis, Antoni

Grupos y Plataformas de I+D+i

Abstract

OBJECTIVE: In acute heart failure (AHF), early assessment of spot urinary sodium (UNa) has emerged as a useful biomarker for risk stratification and monitoring. The objective of this study was to investigate (a) whether early spot UNa predicts 24-h diuretic efficiency and (b) the clinical factors associated with early spot UNa in patients with AHF and concomitant renal dysfunction (RD).; METHODS: This is a post hoc analysis of the IMPROVE-HF trial, in which 160 patients with AHF and RD (estimated glomerular filtrate rate [eGFR] <60 mL/min/1.73 m2) were included. Diuretic efficiency was calculated as the net fluid output produced per 40 mg of furosemide equivalents in 24 h. The association between early spot UNa and diuretic efficiency and clinical variables associated with UNa were evaluated using multivariate linear regression analysis. The contribution of the exposures in the predictability of the models was assessed with the coefficient of determination (R2).; RESULTS: The mean age of the study population was 78 ± 8 years. The median (interquartile range) diuretic efficiency, early spot UNa, aminoterminal pro-brain natriuretic peptide, and eGFR were 747 (490-1,167) mL, 90 mmol/L (65-111), 7,765 pg/mL (3,526-15,369), and 33.7 ± 11.3 mL/min/1.73 m2, respectively. In a multivariate setting, lower UNa was significantly and nonlinearly associated with lower diuretic efficiency (p = 0.001), explaining the 44.4% of the model predictability. Natremia and surrogates of congestion emerged as the main factors related to UNa.; CONCLUSIONS: In patients with AHF and RD at presentation, early spot UNa was inversely related to 24-h diuretic efficiency. © 2020 S. Karger AG, Basel.

© 2020 S. Karger AG, Basel

Datos de la publicación

ISSN/ISSNe:
1664-3828, 1664-5502

CardioRenal Medicine  S. Karger AG

Tipo:
Article
Páginas:
362-372
PubMed:
32721973

Citas Recibidas en Web of Science: 5

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Keywords

  • Acute heart failure; Urinary sodium; Diuretic efficiency; Renal dysfunction; Congestion

Financiación

INSTITUTO SALUD CARLOS III (CB16/11/00420)
INSTITUTO SALUD CARLOS III (PIE15/00013)

Proyectos y Estudios Clínicos

A multidisciplinary project to advance in basic mechanisms, diagnosis, prediction, and prevention of cardiac damage in reperfused acute myocardial infarction.

Investigador Principal: VICENT BODÍ PERIS

PIE15/00013 . INSTITUTO SALUD CARLOS III . 2016

INCORPORACIÓN DE NUEVAS ÁREAS TEMÁTICAS Y NUEVOS GRUPOS AL CONSORCIO CIBER

Investigador Principal: JUAN SANCHIS FORES

CB16/11/00420 . INSTITUTO SALUD CARLOS III

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