Skip to main content
Journal cover image

Lower urine sodium predicts longer length of stay in acute heart failure patients: Insights from the ROSE AHF trial.

Publication ,  Journal Article
Cunningham, JW; Sun, J-L; Mc Causland, FR; Ly, S; Anstrom, KJ; Lindenfeld, J; Givertz, MM; Stevenson, LW; Lakdawala, NK
Published in: Clin Cardiol
January 2020

BACKGROUND: In patients hospitalized with acute heart failure (AHF), low urine sodium concentration (UNa ) after diuretic treatment may identify patients at risk for longer length of stay (LOS) and adverse events. We investigated the prognostic significance of 24-hour cumulative postdiuretic urine sodium concentration in a multicenter clinical trial population. METHODS: The Renal Optimization Strategies Evaluation AHF (ROSE AHF) trial randomized 360 patients with AHF and renal dysfunction receiving intravenous diuretic to dopamine, nesiritide, or placebo. Sodium concentration was measured in cumulative urine sample collected during the first 24 hours after randomization in 298 patients. Based on prior studies, lower UNa was defined as ≤60 mmol/L. RESULTS: Lower UNa was present in 142 (48%) patients, who had longer LOS (7 days vs 5 days, P < .001) and less 72-hour weight loss (5.7 lb vs 9.0 lb, P < .001). These associations persisted after controlling for baseline estimated glomerular filtration rate and outpatient furosemide dose. Lower UNa did not modify the null effects of dopamine or nesiritide on clinical outcomes. Results were similar for spot rather than cumulative 24-hour UNa concentration. CONCLUSION: In patients hospitalized for AHF and renal dysfunction, UNa  ≤ 60 mmol/L during the first 24 hours of diuresis identifies patients at risk for prolonged hospitalization but does not provide an indication for adjunctive dopamine or nesiritide.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Clin Cardiol

DOI

EISSN

1932-8737

Publication Date

January 2020

Volume

43

Issue

1

Start / End Page

43 / 49

Location

United States

Related Subject Headings

  • United States
  • Sodium
  • Risk Factors
  • Renal Insufficiency
  • Prognosis
  • Middle Aged
  • Male
  • Length of Stay
  • Humans
  • Heart Failure
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Cunningham, J. W., Sun, J.-L., Mc Causland, F. R., Ly, S., Anstrom, K. J., Lindenfeld, J., … Lakdawala, N. K. (2020). Lower urine sodium predicts longer length of stay in acute heart failure patients: Insights from the ROSE AHF trial. Clin Cardiol, 43(1), 43–49. https://doi.org/10.1002/clc.23286
Cunningham, Jonathan W., Jie-Lena Sun, Finnian R. Mc Causland, Samantha Ly, Kevin J. Anstrom, Joann Lindenfeld, Michael M. Givertz, Lynne W. Stevenson, and Neal K. Lakdawala. “Lower urine sodium predicts longer length of stay in acute heart failure patients: Insights from the ROSE AHF trial.Clin Cardiol 43, no. 1 (January 2020): 43–49. https://doi.org/10.1002/clc.23286.
Cunningham JW, Sun J-L, Mc Causland FR, Ly S, Anstrom KJ, Lindenfeld J, et al. Lower urine sodium predicts longer length of stay in acute heart failure patients: Insights from the ROSE AHF trial. Clin Cardiol. 2020 Jan;43(1):43–9.
Cunningham, Jonathan W., et al. “Lower urine sodium predicts longer length of stay in acute heart failure patients: Insights from the ROSE AHF trial.Clin Cardiol, vol. 43, no. 1, Jan. 2020, pp. 43–49. Pubmed, doi:10.1002/clc.23286.
Cunningham JW, Sun J-L, Mc Causland FR, Ly S, Anstrom KJ, Lindenfeld J, Givertz MM, Stevenson LW, Lakdawala NK. Lower urine sodium predicts longer length of stay in acute heart failure patients: Insights from the ROSE AHF trial. Clin Cardiol. 2020 Jan;43(1):43–49.
Journal cover image

Published In

Clin Cardiol

DOI

EISSN

1932-8737

Publication Date

January 2020

Volume

43

Issue

1

Start / End Page

43 / 49

Location

United States

Related Subject Headings

  • United States
  • Sodium
  • Risk Factors
  • Renal Insufficiency
  • Prognosis
  • Middle Aged
  • Male
  • Length of Stay
  • Humans
  • Heart Failure