Sodium

A small, single-centre study has suggested that increasing sodium intake does not affect weight or kidney function in patients hospitalized for acute ...

Blood urea nitrogen levels increased more with placebo vs sodium chloride (11 vs 3.1 mEq/L; p=0.02). This lack of difference applied to both change in creatinine levels (0.04 [sodium chloride] vs 0.15 [placebo] mg/dL; p=0.30) and change in weight (–4.0 vs –4.6 kg; p=0.57). At 96 hours, change in creatinine levels and weight did not significantly differ between patients assigned to sodium chloride and placebo (p=0.33). There was no significant difference between groups in terms of serious adverse events, though the trial was not powered to detect between-group differences. However, our study did not show such benefits with raising oral salt supplementation and gave us an indication that keeping a low-salt diet during aggressive diuretic therapy may not be as effective as we thought,” added Tang. Total recorded urine output was also comparable between groups (10,000 vs 9,400 mL; p=0.61). The most common medications used were beta-blockers, mineralocorticoid receptor antagonists, and hydralazine and/or isosorbide dinitrate (72, 52, and 52 percent, respectively). In the double-blind OSPREY-AHF* trial, 65 adults (mean age 70 years, 37 percent female) hospitalized (non-ICU) with acute HF were randomized 1:1 to receive oral sodium chloride (2 g) or placebo TID during intravenous diuretic therapy in addition to the sodium-restricted diet provided at the hospital. The most common comorbidities were hypertension and atrial fibrillation (71 and 68 percent, respectively). There were four and three deaths, respectively, within 90 days. Patients needed to have NT-proBNP levels ≥1,000 ng/L and be treated with furosemide ≥10 mg/hour to be included. Baseline characteristics were generally well balanced between groups, though patients assigned to the sodium chloride group had higher serum creatinine levels compared with placebo (2.0 vs 1.6 mEq/L).