The utility of urine sodium-guided diuresis during acute decompensated heart failure

被引：3

作者：

Siddiqi, Hasan K. ^{[1
]}

Cox, Zachary L. ^{[2
,3
]}

Stevenson, Lynne W. ^{[1
]}

Damman, Kevin ^{[4
]}

ter Maaten, Jozine M. ^{[4
]}

Bales, Brian ^{[5
]}

Han, Jin H. ^{[5
,6
]}

Ivey-Miranda, Juan B. ^{[7
,8
]}

Lindenfeld, JoAnn ^{[1
]}

Miller, Karen F. ^{[5
]}

Ooi, Henry ^{[1
,9
]}

Rao, Veena S. ^{[7
]}

Schlendorf, Kelly ^{[1
]}

Storrow, Alan B. ^{[5
]}

Walsh, Ryan ^{[5
]}

Wrenn, Jesse ^{[5
]}

Testani, Jeffrey M. ^{[7
]}

Collins, Sean P. ^{[5
,6
]}

机构：

[1] Vanderbilt Univ, Med Ctr, Dept Med, North Tower,1215 21st Ave South,5th Floor,Off 5033, Nashville, TN 37232 USA

[2] Lipscomb Univ, Dept Pharm, Coll Pharm, Nashville, TN USA

[3] Vanderbilt Univ, Med Ctr, Dept Pharm, Nashville, TN USA

[4] Univ Groningen, Univ Med Ctr Groningen, Dept Cardiol, Groningen, Netherlands

[5] Vanderbilt Univ, Med Ctr, Dept Emergency Med, Nashville, TN USA

[6] Tennessee Valley Healthcare Syst, Geriatr Res Educ & Clin Ctr, Nashville, TN USA

[7] Yale Univ, Dept Internal Med, Sch Med, New Haven, CT USA

[8] Hosp Cardiol, Inst Mexicano Seguro Social, Mexico City, Mexico

[9] Vet Affairs Tennessee Valley Healthcare Syst, Dept Med, Nashville, TN USA

来源：

HEART FAILURE REVIEWS | 2024年 / 29卷 / 06期

关键词：

Acute decompensated heart failure; Diuresis; Diuretic strategy; Natriuresis; Decongestion; Urine sodium; NATRIURETIC RESPONSE; INTRAVENOUS DIURETICS; AMERICAN-COLLEGE; OUTCOMES; ULTRAFILTRATION; CONGESTION; EFFICACY; SAFETY; AHF; HOSPITALIZATION;

D O I：

10.1007/s10741-024-10424-8

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Diuresis to achieve decongestion is a central aim of therapy in patients hospitalized for acute decompensated heart failure (ADHF). While multiple approaches have been tried to achieve adequate decongestion rapidly while minimizing adverse effects, no single diuretic strategy has shown superiority, and there is a paucity of data and guidelines to utilize in making these decisions. Observational cohort studies have shown associations between urine sodium excretion and outcomes after hospitalization for ADHF. Urine chemistries (urine sodium +/- urine creatinine) may guide diuretic titration during ADHF, and multiple randomized clinical trials have been designed to compare a strategy of urine chemistry-guided diuresis to usual care. This review will summarize current literature for diuretic monitoring and titration strategies, outline evidence gaps, and describe the recently completed and ongoing clinical trials to address these gaps in patients with ADHF with a particular focus on the utility of urine sodium-guided strategies.

引用

页码：1161 / 1173

页数：13

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