Association of hyponatraemia and renal function in type 1 cardiorenal syndrome.
Association of hyponatraemia and renal function in type 1 cardiorenal syndrome.
复制标题
1 型心肾综合征低钠血症与肾功能的关联。
DOI：
10.1111/eci.13269
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发表时间：
2020
影响因子：
5.5
通讯作者：
Chen Liu
中科院分区：
文献类型：
--
作者：
Weihao Liang;Xin He;Ruicong Xue;Fangfei Wei;Bin Dong;Zexuan Wu;Marvin Owusu-Agyeman;Yuzhong Wu;Yuanyuan Zhou;Yugang Dong;Chen Liu
研究背景急性失代偿性心力衰竭患者低钠血症可预测1型心肾综合征，与不良预后相关。从低钠血症中恢复与急性失代偿性心力衰竭患者的预后较好相关，但其对肾功能的预后价值仍然未知。MethodsWe进行了CARRESS-HF试验的二次分析，所有患者均出现肾功能恶化（血清肌酐较最低值增加≥ 0. 3 mg/dL）。在基线和随机化后第4天和第7天评价患者的血清钠水平。根据低钠血症的状态对患者进行分组：从低钠血症中恢复;无低钠血症;持续性低钠血症;和新发低钠血症。他们的协会与持续恶化的肾功能（血清肌酐≥ 0.3 mg/dL高于出院时的最低值）explored.ResultsA共118例患者患有持续恶化的肾功能。基线低钠血症与肾功能持续恶化无关（优势比= 0.495，P = 0.086）。在研究人群中，低钠血症恢复组患者的肾功能持续恶化风险最低。此外，基线血清钠水平与肾功能持续恶化的风险无关（比值比= 1.055，P = .233），而第4天血清钠水平的升高（比值比= 0.858，P = .003），第7天（比值比= 0.821，P <0.001）显著预测肾功能持续恶化的风险较低。结论低钠血症的恢复与肾功能持续恶化的风险较低有关，提示纠正低钠血症可改善1型心肾综合征急性失代偿性心力衰竭患者的肾脏预后。
BackgroundHyponatraemia predicts type 1 cardiorenal syndrome in acute decompensated heart failure patients, which associates with poor outcome. Recovery from hyponatraemia has been found to associate with better outcome in acute decompensated heart failure patients, but its prognostic value regarding renal function remains unknown.MethodsWe performed a secondary analysis of CARRESS‐HF trial, and all patients included had worsening renal function (≥0.3 mg/dL increase in serum creatinine than the nadir). The serum sodium levels of patients were evaluated at baseline and day 4 and day 7 after randomization. Patients were grouped according to the status of hyponatraemia: recovery from hyponatraemia; no hyponatraemia; persistent hyponatraemia; and new‐onset hyponatraemia. Their associations with persistent worsening renal function (serum creatinine ≥ 0.3 mg/dL higher than the nadir at discharge) were explored.ResultsA total of 118 patients suffered from persistent worsening renal function. Baseline hyponatraemia was not associated with persistent worsening renal function (odds ratio = 0.495,P= .086). Patients in the recovery from hyponatraemia group had a lowest risk of persistent worsening renal function among the study population. Further, baseline serum sodium level was not associated with the risk of persistent worsening renal function (odds ratio = 1.055,P= .233), while the increases in serum sodium level at day 4 (odds ratio = 0.858,P= .003) and at day 7 (odds ratio = 0.821,P< .001) significantly predicted a lower risk of persistent worsening renal function.ConclusionsRecovery from hyponatraemia associates with a lower risk of persistent worsening renal function, suggesting that hyponatraemia correction may improve renal outcomes in acute decompensated heart failure patients with type 1 cardiorenal syndrome.