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Prognostic Role of Hyponatremia in Heart Failure Patients Depending on Renal Disease: Clinical Evidence

机译：肾脏疾病患者低钠血症在心力衰竭患者的预后作用：临床证据

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Aim: Hyponatremia is very often associated with renal disease in patients with heart failure (HF) and, when present, determines a poor outcome. We investigated the role of hyponatremia in HF patients in whom the presence or absence renal insufficiency was accurately predefined. Methods: This was a cohort study based on the Spanish National Registry on Heart Failure (RICA), a multicenter, prospective registry that enrolls patients admitted for decompensated HF who were subsequently followed up for 1 year. We classified patients into 4 groups according to the presence or absence of renal disease defined by the hematocrit, urea, and gender formula (HUGE) and then according to the presence of hyponatremia (Na <= 135 mEq/L). Results: A total of 3,478 patients were included. Hyponatremia was more prevalent in the group with renal disease (22.1%) than without (18.4%). During admission, both groups with hyponatremia had more complications than those with normal serum sodium. During the 1-year follow-up, patients with hyponatremia and renal disease had a significantly worse outcome (HF mortality and readmission), HR 1.87, 95% CI 1.54-2.29, p < 0.001, compared to those with hyponatremia without renal disease, HR 1.01, 95% CI 0.79-1.3, p = 0.94. Conclusions: Hyponatremia is more prevalent in patients with renal insufficiency, and outcome is poorest when both renal disease and hyponatremia coexist. Patients with hyponatremia without renal disease show no differences in outcome compared to those without hyponatremia.
机译：目的：低钠血症通常与心力衰竭（HF）患者的肾病有关，并且当存在时，决定了差的结果。我们调查了低钠血症在HF患者中的作用，其中存在或缺乏肾功能不全准确预定义。方法：这是一项基于西班牙国家登记处关于心力衰竭（RICA），多中心的预期登记处的队列研究，这些注册登记患者被录取的患者随后随后随后进行1年。根据血细胞比容，尿素和性别配方（巨大）所定义的肾脏疾病，将患者分为4组，然后根据低钠血症（Na <= 135meq / L）。结果：共用3,478名患者。肾脏疾病（22.1％）的群体中低钠血症比没有（18.4％）更普遍。在入院期间，两组患有低钠血症的群体比具有正常血清钠的群体具有更多的并发症。在1年的随访期间，患有低钠血症和肾病的患者的结果显着更差（HF死亡率和再次入学），HR 1.87,95％CI 1.54-2.29，P <0.001，与没有肾病的低血糖血症相比， HR 1.01,95％CI 0.79-1.3，P = 0.94。结论：肾功能不全，肾功能不全患者的低钠血症更为普遍，当肾病和低钠血症共存时，结果最差。没有肾病的低钠血症患者显示出与没有低钠血症的患者的差异。

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