rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2014-10-6-640-645rpcardio-301Research ArticleINNOVATIVE CARDIOLOGYИННОВАЦИОННАЯ КАРДИОЛОГИЯPROGNOSTIC IMPACT OF COMMUNITY-ACQUIRED AND HOSPITAL-ACQUIRED HYPONATREMIA IN PATIENTS WITH DECOMPENSATED HEART FAILUREПРОГНОСТИЧЕСКОЕ ЗНАЧЕНИЕ ДОГОСПИТАЛЬНОЙ И ВНУТРИГОСПИТАЛЬНОЙ ГИПОНАТРИЕМИИ ПРИ ДЕКОМПЕНСАЦИИ ХРОНИЧЕСКОЙ СЕРДЕЧНОЙ НЕДОСТАТОЧНОСТИЩекочихинД. Ю.ShchekochikhinD. Yu.

к.м.н., ассистент кафедры профилактической и неотложной кардиологи Института профессионального образования

119991, Москва, ул. Трубецкая, 8, стр. 2

Trubetskaya ul. 8-2, Moscow, 119991 Russia

agishm@list.ruКопыловФ. Ю.KopylovPh. Yu.

д.м.н., профессор той же кафедры

119991, Москва, ул. Трубецкая, 8, стр. 2

Trubetskaya ul. 8-2, Moscow, 119991 Russia

КозловскаяН. Л.KozlovskayaN. L.

д.м.н., профессор, профессор кафедры нефрологии и гемодиализа Института профессионального образования

119991, Москва, ул. Трубецкая, 8, стр. 2

Trubetskaya ul. 8-2, Moscow, 119991 Russia

СыркинА. Л.SyrkinA. L.

д.м.н., профессор, зав. кафедрой профилактической и неотложной кардиологии Института профессионального образования

119991, Москва, ул. Трубецкая, 8, стр. 2

Trubetskaya ul. 8-2, Moscow, 119991 Russia

Первый Московский Государственный Медицинский Университет им. И.М. СеченоваРоссияI.M. Sechenov First Moscow State Medical UniversityRussian Federation201425092015106640645Copyright © Shchekochikhin D.Y., Kopylov P.Y., Kozlovskaya N.L., Syrkin A.L., 20152015Щекочихин Д.Ю., Копылов Ф.Ю., Козловская Н.Л., Сыркин А.Л.Shchekochikhin D.Y., Kopylov P.Y., Kozlovskaya N.L., Syrkin A.L.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/301Aim

Aim. To compare prognostic impact of community-acquired and hospital-acquired hyponatremia in hospitalized patients with decompensated heart failure Material and methods. Data of 120 patients with decompensated heart failure were analyzed. Hyponatremia was defined as serum sodium concentration of 135 mmol/l or less. Several outcomes were analyzed: mortality, transfer to intensive care unit (ICU), resistance to loop diuretics and worsening renal function.

Results

Results. 13.0% of patients had community-acquired hyponatremia, 9.6% - hospital-acquired hyponatremia. Community-acquired hyponatremia was associated with increased mortality [odds ratio (OR)=7.8], admission to ICU (OR=19.1) and resistance to loop diuretics (OR=4.8). Hospital-acquired hyponatremia was associated with worsening renal function (OR=12.4).

Conclusion

Conclusion. Both, community-acquired and hospital hyponatremia have negative impact in hospitalized patients with decompensated heart failure.

Цель

Цель. Сравнить прогностическое значение догоспитальной и внутригоспитальной гипонатриемии на общие и почечные исходы госпитализации у пациентов с декомпенсацией хронической сердечной недостаточности (ХСН).

Материал и методы

Материал и методы. Обследовано 120 пациентов, госпитализированных в связи с декомпенсацией ХСН. Гипонатриемию определяли как снижение уровня натрия крови ≤135 ммоль/л. Оценивали следующие исходы: летальный исход, необходимость перевода в отделение интенсивной терапии, развитие резистентности к петлевым диуретикам и ухудшение функции почек (развитие острого кардиоренального синдрома).

Результаты

Результаты. Догоспитальная гипонатриемия выявлена у 13,0% пациентов, внутригоспитальная – у 9,6%. Наличие догоспитальной гипонатриемии значимо увеличивало риск развития летального исхода, перевода в отделение интенсивной терапии и развития резистентности к диуретикам [отношение шансов (ОШ)=7,8; 19,1 и 4,8, соответственно]. Наличие внутригоспитальной гипонатриемии увеличивало риск развития острого кардиоренального синдрома (ОШ=12,4).

Заключение

Заключение. Продемонстрировано неблагоприятное значение догоспитальной и внутригоспитальной гипонатриемии у больных декомпенсированной ХСН на общий и почечный прогноз.

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The authors declare that there are no conflicts of interest present.