MỐI LIÊN QUAN GIỮA BÀI XUẤT NATRI NIỆU 6 GIỜ VỚI ĐÁP ỨNG LỢI TIỂU QUAI Ở BỆNH NHÂN SUY TIM CẤP

Abstract

Introduction: Aggressive, correct and sufficient diuretic treatment at early stage in acute heart failure (AHF) patients is very important. In addition to spot urinary sample, the 6-hour urinary sodium excretion is increasing interest because of the stability of the results, as well as the ability to predict loop diuretic response early and predict in-hospital and post-discharge cardiovascular events. Objectives: We aim to determine the relationship between 6-hour urinary sodium excretion with clinical measurements in assessing loop diuretic response of AHF patients and their predictive role of in-hospital worsening heart failure (WHF). Methods: A retrospective descriptive cross-sectional study was performed on 51 AHF patients admitted to Cardiology Department - Cho Ray Hospital from 09/2020 to 12/2021. After loop diuretic treatment,, the patient's continuously urine sample was collected to determine total urinary sodium excretion during 6 hours. Results: 6-hour urinary sodium excretion was significantly positively correlated with the clinical scales: weight loss, urine volume, and negative balance after 24 hours. With the same cut-off point of 63.2 mmol, 6-hour urinary sodium excretion could well predict all three events: 24-hour weight loss < 1 kg, 24-hour urine volume < 2100 mL, and 24-hour net fluid loss < 1500 mL. Patients with a lower baseline 6-hour urinary sodium excretion were statistically significantly associated with a higher likelihood of progressing to in-hospital WHF. Conclusion: Lower 6-hour urinary sodium excretion is associated with poorer loop diuretic response, and is associated with an increased likelihood of progression to in-hospital WHF.