Abstract: PO1111
Attenuated Urinary Sodium and Volume in Response to Saline Load in Heart Failure with Preserved Ejection Fraction
Session Information
- Salt, Potassium, and Water Balance: Clinical
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Fluid, Electrolyte, and Acid-Base Disorders
- 902 Fluid, Electrolyte, and Acid-Base Disorders: Clinical
Authors
- Agarwal, Adhish, University of Utah Health, Salt Lake City, Utah, United States
- Beddhu, Srinivasan, University of Utah Health, Salt Lake City, Utah, United States
- Boucher, Robert E., University of Utah Health, Salt Lake City, Utah, United States
- Rodan, Aylin R., University of Utah Health, Salt Lake City, Utah, United States
- Mohammad, Habeeb, University of Utah Health, Salt Lake City, Utah, United States
- Wei, Guo, University of Utah Health, Salt Lake City, Utah, United States
- Shah, Kevin S., University of Utah Health, Salt Lake City, Utah, United States
- Fang, James Chen-Tson, University of Utah Health, Salt Lake City, Utah, United States
- Cheung, Alfred K., University of Utah Health, Salt Lake City, Utah, United States
Background
Heart failure (HF) is characterized by fluid overload due to impaired sodium (Na) excretion. Impaired urinary Na excretion in response to intravenous Na load has been demonstrated in HF with reduced ejection fraction (HFrEF). We hypothesized that patients with HF with preserved ejection fraction (HFpEF) also have impaired urinary sodium excretion and volume in response to intravenous Na load.
Methods
All participants were instructed to follow a low (2-3 g/d) sodium diet for one week prior to the study and held their diuretic (if prescribed) the morning of the study. After obtaining approval from our center’s institutional review board, saline was infused intravenously at 0.25 ml/kg/min for 60 minutes in 9 patients with HFpEF and 5 controls (no known renal or cardiac disease). Urine output was measured throughout, and blood and urine samples were collected at baseline and 2 hours after ending the infusion. Urine volume and urinary sodium excretion between the groups were compared using Wilcoxon rank-sum tests.
Results
Mean age (yrs) and body mass index (kg/sqm) were 62+/-12 and 36.3+/-8.5 respectively in the HFpEF participants, and 47+/-18 and 24.6+/-3.7 in controls. The fraction of intravenous sodium that was excreted in the urine over 3 hours was significantly lower in cases (12% versus 46%, p=0.003). Mean urine output was significantly lower in cases (2480 versus 3541 ml; p=0.028), even though the total fluid intake (intravenous + oral) during the same time period was similar (2839 versus 3149 ml; p=0.81).
Conclusion
In this rigorous, controlled human pilot study, patients with HFpEF had lower urinary volume and attenuated urinary sodium excretion compared to controls after intravenous sodium and volume load. Data and biospecimens collected in this study should inform the pathogenesis of sodium retention in HFpEF.