Renal function and serum electrolytes in patients with heart failure

Introduction: Renal congestion is a factor of unfavo-rable outcome in patients hospitalized for acute heart failure. Literature data found persistent hyponatremia to be an independent risk factor for mortality and re-hospitalization in patients diagnosed with heart failure.

Objective: We aimed to assess the impact of diuretics on renal function and electrolyte levels of patients with heart failure.

Methods: A retrospective study was performed on pa-tients diagnosed with heart failure who were admitted to our clinic during a 12-month period. Patient demo-graphics, medical history, blood works, echocardio-graphy results and data on in-hospital treatment were collected. Parametric and non-parametric tests were obtained using SPSS, version 20.

Results: A total of 100 patients were enrolled, 50% had heart failure with preserved ejection fraction (HFpEF) and 50% had heart failure with reduced ejection frac-tion (HFrEF). The mean age was 71.10 ± 10.93 y.o. and HFpEF were older (74.66 ± 9.44 vs. 67.54 ± 11.24) and with a female predominance (82% vs. 36%). Maximum urea levels reached while in hospital were differently distributed among the two groups (HFpEF 55.99 ± 33.41 vs. 71.87 ± 43.06, p=0.031); likewise for mini-mum plasma sodium levels (140.66 ± 5.79 vs. 137.64± 9.40, p=0.013), but not maximum creatinine which did not reach statistical significance despite the diffe-rence between subgroups (1.04 ± 0.53 vs. 1.31 ± 0.46, p=0.180). Minimum sodium and total spironolactone dose correlated significantly (r=0.211, p=0.047) as well as maximum urea and total oral furosemide (r=0.297, p=0.005).

Conclusions: We interpreted the need for higher doses of diuretics in patients with reduced ejection fraction as a consequence of more prominent pulmonary and systemic congestion. IV furosemide is needed in order to control congestion, but careful titration of oral doses is advised so as to prevent dehydration.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)