AI Article Synopsis
- Diuretic resistance is when medications that help remove extra fluid from the body don’t work well, which can lead to worse health outcomes for patients with heart problems. Researchers looked at how urine sodium levels (how much sodium is in urine) can help adjust these medications to make them more effective.
- The study included 143 patients with heart failure, and they found that those with low urine sodium levels also had other health issues. They measured urine sodium two hours after giving medicine to patients and looked at how this affected hospital visits and overall survival after 90 days.
- The results showed that low urine sodium was common and often found in patients with serious heart and kidney problems,
Article Abstract
Background: Diuretic resistance is common and results in poor outcome. Spot urine sodium (UrNa) is suggested as a tool to tailor diuretics and improve efficacy of therapy. We prospectively evaluate the prevalence of diuretic resistance, predictors of low spot-UrNa and the prognostic value of spot-UrNa in an unselected ADHF population.
Methods: Patients admitted for ADHF and treated with iv diuretics were included. Spot-UrNa was collected 2 h after administration of an IV diuretic bolus. The main endpoint was a composite of HF re-hospitalizations and all-cause mortality at 90 days follow-up.
Results: 143 patients were included in this study (median age 81 [75 - 85] years, 55 % male), of which 50 % were newly diagnosed with HF. Low spot-UrNa was independently associated with worse renal function, low serum sodium, and systolic blood pressure, previous loop diuretic and SGLT2i use and loop diuretic administered dose. Both absolute spot-UrNa (HR 0.87, 95 % CI 0.79 - 0.95, P=0.003 per 10 mmol/L increase) and a urinary sodium ≥ 100 mmol/l (HR=0.51, 95 % CI 0.27 - 0.97, P=0.04) significantly predicted the composite endpoint. This association was no longer significant after correction for confounders. Patients with low spot-UrNa attained longer IV diuretic treatment and a higher cumulative IV diuretic dose.
Conclusions: Spot-UrNa is prevalent and occurs more often in patients with more progressed cardio-renal disease. Spot-UrNa significantly predicts 90-day HF hospital-free survival in ADHF. Further studies are needed evaluating the effect of UrNa guided diuretic treatment on clinical endpoints.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11426127 | PMC |
| http://dx.doi.org/10.1016/j.ijcha.2024.101509 | DOI Listing |
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