Role of Early Assesment of Diuresis and Natriuresis in Detecting In-Hospital Diuretic Resistance in Acute Heart Failure

Background and Purpose: European Guidelines recommend early evaluation of diuresis and natriuresis after the first administration of diuretic to identify patients with insufficient diuretic response during acute heart failure. The aim of this work is to evaluate the prevalence and characteristics of...

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Authors: García-Magallón, Belén, Cobo-Marcos, Marta, Martiarena, Aitor Dávila, Hernández, Esther Montero, Martín Jiménez, Maria Luisa, García, Aránzazu Martín, De Castro Campos, Daniel, Martín, Paula Vela, Terciado, Fernando Hernández, González, Ramón Garrido, Matutano Muñoz, Andrea, Escribano García, Daniel, Domínguez, Fernando, Sainz Herrero, Ana, Gómez Peñalba, Camino, Garcia-Pavia, Pablo, Segovia, Javier
Format: article
Publication Date:2022
Country:España
Institution:Universidad de Málaga
Repository:DDFV. Repositorio Institucional de la Universidad Francisco de Vitoria
Language:English
OAI Identifier:oai:ddfv.ufv.es:10641/6584
Online Access:https://hdl.handle.net/10641/6584
Access Level:Open access
Keyword:acute heart failure
diuretic
diuretic resistance
diuretic response
natriuresis
Physiology
Physiology (medical)
Journal Article
Yes
yes
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spelling Role of Early Assesment of Diuresis and Natriuresis in Detecting In-Hospital Diuretic Resistance in Acute Heart FailureGarcía-Magallón, BelénCobo-Marcos, MartaMartiarena, Aitor DávilaHernández, Esther MonteroMartín Jiménez, Maria LuisaGarcía, Aránzazu MartínDe Castro Campos, DanielMartín, Paula VelaTerciado, Fernando HernándezGonzález, Ramón GarridoMatutano Muñoz, AndreaEscribano García, DanielDomínguez, FernandoSainz Herrero, AnaGómez Peñalba, CaminoGarcia-Pavia, PabloSegovia, Javieracute heart failurediureticdiuretic resistancediuretic responsenatriuresisPhysiologyPhysiology (medical)Journal ArticleYesyesBackground and Purpose: European Guidelines recommend early evaluation of diuresis and natriuresis after the first administration of diuretic to identify patients with insufficient diuretic response during acute heart failure. The aim of this work is to evaluate the prevalence and characteristics of patients with insufficient diuretic response according to this new algorithm. Methods: Prospective observational single centre study of consecutive patients with acute heart failure and congestive signs. Clinical evaluation, echocardiography and blood tests were performed. Diuretic naïve patients received 40 mg of intravenous furosemide. Patients on an oupatient diuretic regimen received 2 times the ambulatory dose. The diuresis volume was assessed 6 h after the first loop diuretic administration, and a spot urinary sample was taken after 2 h. Insufficient diuretic response was defined as natriuresis <70 mEq/L or diuresis volume <600 ml. Results: From January 2020 to December 2021, 73 patients were included (59% males, median age 76 years). Of these, 21 patients (28.8%, 95%CI 18.4; 39.2) had an insufficient diuretic response. Diuresis volume was <600 ml in 13 patients (18.1%), and 12 patients (16.4%) had urinary sodium <70 mEq/L. These patients had lower systolic blood pressure, worse glomerular filtration rate, and higher aldosterone levels. Ambulatory furosemide dose was also higher. These patients required more frequently thiazides and inotropes during admission. Conclusion: The diagnostic algorithm based on diuresis and natriuresis was able to detect up to 29% of patients with insufficient diuretic response, who showed some characteristics of more advanced disease.Facultad de Medicina20222022-05-0220222022-05-02journal articlehttp://purl.org/coar/resource_type/c_6501info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/10641/6584reponame:DDFV. Repositorio Institucional de la Universidad Francisco de Vitoriainstname:Universidad de MálagaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2http://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:ddfv.ufv.es:10641/65842026-06-11T12:44:57Z
dc.title.none.fl_str_mv Role of Early Assesment of Diuresis and Natriuresis in Detecting In-Hospital Diuretic Resistance in Acute Heart Failure
title Role of Early Assesment of Diuresis and Natriuresis in Detecting In-Hospital Diuretic Resistance in Acute Heart Failure
spellingShingle Role of Early Assesment of Diuresis and Natriuresis in Detecting In-Hospital Diuretic Resistance in Acute Heart Failure
García-Magallón, Belén
acute heart failure
diuretic
diuretic resistance
diuretic response
natriuresis
Physiology
Physiology (medical)
Journal Article
Yes
yes
title_short Role of Early Assesment of Diuresis and Natriuresis in Detecting In-Hospital Diuretic Resistance in Acute Heart Failure
title_full Role of Early Assesment of Diuresis and Natriuresis in Detecting In-Hospital Diuretic Resistance in Acute Heart Failure
title_fullStr Role of Early Assesment of Diuresis and Natriuresis in Detecting In-Hospital Diuretic Resistance in Acute Heart Failure
title_full_unstemmed Role of Early Assesment of Diuresis and Natriuresis in Detecting In-Hospital Diuretic Resistance in Acute Heart Failure
title_sort Role of Early Assesment of Diuresis and Natriuresis in Detecting In-Hospital Diuretic Resistance in Acute Heart Failure
dc.creator.none.fl_str_mv García-Magallón, Belén
Cobo-Marcos, Marta
Martiarena, Aitor Dávila
Hernández, Esther Montero
Martín Jiménez, Maria Luisa
García, Aránzazu Martín
De Castro Campos, Daniel
Martín, Paula Vela
Terciado, Fernando Hernández
González, Ramón Garrido
Matutano Muñoz, Andrea
Escribano García, Daniel
Domínguez, Fernando
Sainz Herrero, Ana
Gómez Peñalba, Camino
Garcia-Pavia, Pablo
Segovia, Javier
author García-Magallón, Belén
author_facet García-Magallón, Belén
Cobo-Marcos, Marta
Martiarena, Aitor Dávila
Hernández, Esther Montero
Martín Jiménez, Maria Luisa
García, Aránzazu Martín
De Castro Campos, Daniel
Martín, Paula Vela
Terciado, Fernando Hernández
González, Ramón Garrido
Matutano Muñoz, Andrea
Escribano García, Daniel
Domínguez, Fernando
Sainz Herrero, Ana
Gómez Peñalba, Camino
Garcia-Pavia, Pablo
Segovia, Javier
author_role author
author2 Cobo-Marcos, Marta
Martiarena, Aitor Dávila
Hernández, Esther Montero
Martín Jiménez, Maria Luisa
García, Aránzazu Martín
De Castro Campos, Daniel
Martín, Paula Vela
Terciado, Fernando Hernández
González, Ramón Garrido
Matutano Muñoz, Andrea
Escribano García, Daniel
Domínguez, Fernando
Sainz Herrero, Ana
Gómez Peñalba, Camino
Garcia-Pavia, Pablo
Segovia, Javier
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Facultad de Medicina
dc.subject.none.fl_str_mv acute heart failure
diuretic
diuretic resistance
diuretic response
natriuresis
Physiology
Physiology (medical)
Journal Article
Yes
yes
topic acute heart failure
diuretic
diuretic resistance
diuretic response
natriuresis
Physiology
Physiology (medical)
Journal Article
Yes
yes
description Background and Purpose: European Guidelines recommend early evaluation of diuresis and natriuresis after the first administration of diuretic to identify patients with insufficient diuretic response during acute heart failure. The aim of this work is to evaluate the prevalence and characteristics of patients with insufficient diuretic response according to this new algorithm. Methods: Prospective observational single centre study of consecutive patients with acute heart failure and congestive signs. Clinical evaluation, echocardiography and blood tests were performed. Diuretic naïve patients received 40 mg of intravenous furosemide. Patients on an oupatient diuretic regimen received 2 times the ambulatory dose. The diuresis volume was assessed 6 h after the first loop diuretic administration, and a spot urinary sample was taken after 2 h. Insufficient diuretic response was defined as natriuresis <70 mEq/L or diuresis volume <600 ml. Results: From January 2020 to December 2021, 73 patients were included (59% males, median age 76 years). Of these, 21 patients (28.8%, 95%CI 18.4; 39.2) had an insufficient diuretic response. Diuresis volume was <600 ml in 13 patients (18.1%), and 12 patients (16.4%) had urinary sodium <70 mEq/L. These patients had lower systolic blood pressure, worse glomerular filtration rate, and higher aldosterone levels. Ambulatory furosemide dose was also higher. These patients required more frequently thiazides and inotropes during admission. Conclusion: The diagnostic algorithm based on diuresis and natriuresis was able to detect up to 29% of patients with insufficient diuretic response, who showed some characteristics of more advanced disease.
publishDate 2022
dc.date.none.fl_str_mv 2022
2022-05-02
2022
2022-05-02
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/10641/6584
url https://hdl.handle.net/10641/6584
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2

http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2

http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:DDFV. Repositorio Institucional de la Universidad Francisco de Vitoria
instname:Universidad de Málaga
instname_str Universidad de Málaga
reponame_str DDFV. Repositorio Institucional de la Universidad Francisco de Vitoria
collection DDFV. Repositorio Institucional de la Universidad Francisco de Vitoria
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,81155

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