PMID- 17992382
OWN - NLM
STAT- MEDLINE
DCOM- 20080718
LR  - 20190606
IS  - 1678-4170 (Electronic)
IS  - 0066-782X (Linking)
VI  - 89
IP  - 4
DP  - 2007 Oct
TI  - Hypertonic saline solution for renal failure prevention in patients with 
      decompensated heart failure.
PG  - 251-5
AB  - BACKGROUND: Hyponatremia and congestive phenomena indicate a bad prognosis in 
      decompensated heart failure. The occurrence of renal failure is associated to an 
      increased death risk. OBJECTIVE: To evaluate the safety and efficacy of the 
      hypertonic saline solution in patients with decompensated heart failure for renal 
      failure prevention. METHODS: Patients with decompensated heart failure, 
      congestion and hyponatremia participated in the study. In addition to the 
      standard treatment, the patients received hypertonic saline solution and were 
      submitted to clinical as well as laboratory assessment. RESULTS: Nine patients 
      were enrolled in the study. Mean age was 55 + 14.2 years, being 5 male (55.5%) 
      and 4 (44.5%) female patients. All of them presented functional class III-IV of 
      the New York Heart Association (NYHA), and 5 (55.5%) received dobutamine. All of 
      them presented initial creatinine > 1.4 mg/dl. The mean tonicity of the solution 
      was 4.39% + 0.018% (2.5% to 7.5%) and the duration of treatment was 4.9 days + 
      4.1 days (1-15 days). There were no severe adverse effects; none of the patients 
      presented clinical worsening or neurologic disorders; hypokalemia occurred in 4 
      cases (44.5%). The comparison of the variables before and after treatment showed 
      a decrease in urea (105 mg/dl + 74.8 mg/dl vs. 88 mg/dl + 79.4 mg/dl; p = 0.03) 
      and increase in the urinary volume (1,183 ml/day vs. 1,778 ml/day; p = 0.03); 
      there was no tendency to creatinine decrease (2.0 mg/dl + 0.8 mg/dl vs. 1.7 mg/dl 
      + 1.0 mg/dl; p = 0.08). Despite the elevation in sodium levels (131 mEq/l + 2.8 
      mEq/l vs. 134 mEq/l + 4.9 mEq/l) and weight decrease (69.5 kg + 18.6 kg vs. 68.2 
      kg + 17.1 kg), there was no statistically significant difference. CONCLUSION: The 
      use of hypertonic saline solution in patients with decompensated heart failure 
      can be a safe therapeutic method and potentially related to clinical improvement 
      and renal failure prevention.
FAU - Issa, Victor Sarli
AU  - Issa VS
AD  - Instituto do Coracao, Hospital das Clinicas, Faculdade de Medicina, Universidade 
      de Sao Paulo, Sao Paulo, SP, Brasil. victorissa@cardiol.br
FAU - Bacal, Fernando
AU  - Bacal F
FAU - Mangini, Sandrigo
AU  - Mangini S
FAU - Carneiro, Rodrigo Moreno Dias
AU  - Carneiro RM
FAU - Azevedo, Cristiano Humberto Naves de Freitas
AU  - Azevedo CH
FAU - Chizzola, Paulo Roberto
AU  - Chizzola PR
FAU - Ferreira, Silvia Moreira Ayub
AU  - Ferreira SM
FAU - Bocchi, Edimar Alcides
AU  - Bocchi EA
LA  - eng
LA  - por
PT  - Clinical Trial
PT  - Journal Article
PL  - Brazil
TA  - Arq Bras Cardiol
JT  - Arquivos brasileiros de cardiologia
JID - 0421031
RN  - 0 (Biomarkers)
RN  - 0 (Cardiotonic Agents)
RN  - 0 (Diuretics)
RN  - 0 (Saline Solution, Hypertonic)
RN  - 3S12J47372 (Dobutamine)
RN  - 7LXU5N7ZO5 (Furosemide)
RN  - 8W8T17847W (Urea)
RN  - 9NEZ333N27 (Sodium)
RN  - AYI8EX34EU (Creatinine)
RN  - RWP5GA015D (Potassium)
SB  - IM
MH  - Biomarkers/blood
MH  - Cardiotonic Agents/therapeutic use
MH  - Creatinine/blood
MH  - Diuretics/therapeutic use
MH  - Dobutamine/therapeutic use
MH  - Female
MH  - Furosemide/therapeutic use
MH  - Heart Failure/blood/*drug therapy
MH  - Humans
MH  - Hypokalemia/etiology
MH  - Hyponatremia/blood/*drug therapy
MH  - Male
MH  - Middle Aged
MH  - Potassium/blood
MH  - Renal Insufficiency/*prevention & control
MH  - Saline Solution, Hypertonic/adverse effects/*therapeutic use
MH  - Severity of Illness Index
MH  - Sodium/blood
MH  - Time Factors
MH  - Treatment Outcome
MH  - Urea/blood
EDAT- 2007/11/10 09:00
MHDA- 2008/07/19 09:00
CRDT- 2007/11/10 09:00
PHST- 2006/12/12 00:00 [received]
PHST- 2007/04/16 00:00 [accepted]
PHST- 2007/11/10 09:00 [pubmed]
PHST- 2008/07/19 09:00 [medline]
PHST- 2007/11/10 09:00 [entrez]
AID - S0066-782X2007001600007 [pii]
AID - 10.1590/s0066-782x2007001600007 [doi]
PST - ppublish
SO  - Arq Bras Cardiol. 2007 Oct;89(4):251-5. doi: 10.1590/s0066-782x2007001600007.