Dietary sodium modulation of aldosterone activation and renal function during the progression of experimental heart failure

Miller, Wayne L.; Borgeson, Daniel D.; Grantham, J.Aaron; Luchner, Andreas; Redfield, Margaret M.; Burnett, John C.

doi:10.1002/ejhf.212

Cited by 21 publications

(16 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In animal models, sodium restriction in early stages of HF was seen to be associated with early aldosterone activation compared to normal or excess sodium intake [ 36 ]. These findings suggest that sodium restriction in early stages of HF should be avoided to prevent neuroendocrine disease progression.…”

Section: Low Sodium Intake and Worsening Of Hfmentioning

confidence: 99%

Sodium Intake and Heart Failure

Patel

Joseph

2020

IJMS

View full text Add to dashboard Cite

Sodium is an essential mineral and nutrient used in dietary practices across the world and is important to maintain proper blood volume and blood pressure. A high sodium diet is associated with increased expression of β—myosin heavy chain, decreased expression of α/β—myosin heavy chain, increased myocyte enhancer factor 2/nuclear factor of activated T cell transcriptional activity, and increased salt-inducible kinase 1 expression, which leads to alteration in myocardial mechanical performance. A high sodium diet is also associated with alterations in various proteins responsible for calcium homeostasis and myocardial contractility. Excessive sodium intake is associated with the development of a variety of comorbidities including hypertension, chronic kidney disease, stroke, and cardiovascular diseases. While the American College of Cardiology/American Heart Association/Heart Failure Society of America guidelines recommend limiting sodium intake to both prevent and manage heart failure, the evidence behind such recommendations is unclear. Our review article highlights evidence and underlying mechanisms favoring and contradicting limiting sodium intake in heart failure.

show abstract

Section: Low Sodium Intake and Worsening Of Hfmentioning

confidence: 99%

Sodium Intake and Heart Failure

Patel

Joseph

2020

IJMS

View full text Add to dashboard Cite

show abstract

“…3 However, accumulating evidence ranging from the basic sciences to epidemiological studies have challenged this paradigm, suggesting that increased sodium chloride intake may be without deleterious consequences in HF; rather, it may even be beneficial. 4–8 …”

mentioning

confidence: 99%

Hypochloremia and Diuretic Resistance in Heart Failure

Hanberg

Rao

Maaten

et al. 2016

Circ: Heart Failure

135

105

View full text Add to dashboard Cite

Background Recent epidemiologic studies have implicated chloride, rather than sodium, as the driver of poor survival previously attributed to hyponatremia in heart failure (HF). Accumulating basic science evidence has identified chloride as a critical factor in renal salt sensing. Our goal was to probe the physiology bridging this basic and epidemiologic literature. Methods and Results Two HF cohorts were included: (1) Observational: Patients receiving loop diuretics at the Yale Transitional Care Center (YTCC; N=162); (2) Interventional Pilot: Stable outpatients receiving ≥80mg furosemide equivalents were studied before and after three days of 115 mmol/d supplemental lysine chloride (N=10). In YTCC, 31.5% of patients had hypochloremia (chloride ≤96 mmol/L). Plasma renin concentration correlated with serum chloride (r=−0.46, p<0.001) with no incremental contribution from serum sodium (p=0.49). Hypochloremic vs. non-hypochloremic patients exhibited renal wasting of chloride (p=0.04) and of chloride relative to sodium (p=0.01), despite better renal free water excretion (urine osmolality 372±94 mOsm/kg vs. 507±118, p<0.001). Hypochloremia was associated with poor diuretic response (OR=7.3, 95% CI 3.3–16.1, p<0.001). In the interventional pilot, lysine chloride supplementation was associated with an increase in serum chloride levels of 2.2±2.3 mmol/L and the majority of participants experienced findings such as hemoconcentration, weight loss, reduction in NT-proBNP, increased plasma renin activity, and increased blood urea nitrogen to creatinine ratio. Conclusions Hypochloremia is associated with neurohormonal activation and diuretic resistance with chloride depletion as a candidate mechanism. Sodium-free chloride supplementation was associated with increases in serum chloride and changes in several cardio-renal parameters. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT02031354.

show abstract

“…[23][24][25] Extracellular uid retention may play an important role in the progression and deterioration of diseases, indicating that pathophysiologic alterations in body uid composition are associated with poor clinical outcomes. [26][27][28] ECW/TBW as determined by BIA is frequently used to assess abnormal uid status, [22,29] and is a sensitive indicator of hydration changes. [30] Higher ECW/TBW ratios have been reported to predict clinical outcomes in patients with heart failure, liver diseases, renal disorders, and malignancies.…”

Section: Discussionmentioning

confidence: 99%

Body Composition Analysis in Septic Shock Patients Receiving Protocol-Driven Resuscitation Bundle Therapy: A Prospective Observational Study

Chae¹,

Shin²,

Hong³

et al. 2021

Preprint

View full text Add to dashboard Cite

Background: Bio-electrical impedance analysis (BIA) is a rapid, simple, and noninvasive tool for assessing volume status in various diseases. Body composition analysis using BIA may identify factors associated with poor outcomes in critically ill patients. Little is known, however, about the relationship between the results of body composition analysis in the emergency department (ED) and mortality in septic shock patients.Objectives: This study assessed the association between parameters identified by body composition analysis and mortality in patients with septic shock who underwent protocol-driven resuscitation bundle therapy in the ED.Methods: Data were prospectively collected on adult patients with septic shock who underwent protocol-driven resuscitation bundle therapy between December 2019 and December 2020. Body composition was determined in the ED using BIA with the patient in the supine position. Septic shock was defined by sepsis-3 criteria, and the primary outcome was 30-day mortality. Results: The study included 218 patients, of whom 58 (26.6%) died within 30 days. The mean time from ED admission to the measurement of body composition was 5.4 hours. The average ratio of extracellular water (ECW) to total body water (TBW) was significantly higher in non-survivors than in survivors (0.412 vs. 0.400, p=0.001). The optimal ECW/TBW cutoff for predicting 30-day mortality was 0.40, with mortality rates being significantly higher in patients with ECW/TBW >0.4 than in patients with ECW/TBW≦0.4 (37.8% vs. 17.5%, p=0.001). Multivariate analysis showed that ECW/TBW >0.4 (odds ratio [OR], 2.11; 95% confidence interval [CI], 1.05–4.23, p = 0.036), active cancer (OR, 2.39; 95% CI, 1.06–5.38, p=0.036), prothrombin time (OR, 2.77; 95% CI, 1.29–5.93, p=0.009), and initial lactate level (OR, 1.15; 95% CI, 1.03–1.28, p=0.010) were significantly associated with 30-day mortality.Conclusions: The ECW/TBW>0.40 is the only body composition parameter associated with 30-day mortality in patients with septic shock.

show abstract

Dietary sodium modulation of aldosterone activation and renal function during the progression of experimental heart failure

Cited by 21 publications

References 20 publications

Sodium Intake and Heart Failure

Sodium Intake and Heart Failure

Hypochloremia and Diuretic Resistance in Heart Failure

Body Composition Analysis in Septic Shock Patients Receiving Protocol-Driven Resuscitation Bundle Therapy: A Prospective Observational Study

Contact Info

Product

Resources

About