Kidney Week

Abstract: SA-PO032

Low-Sodium Diet and Mortality in Patients with Heart Failure with Worsening Kidney Function during Hospitalization

Session Information

• AKI: Clinical, Outcomes, and Trials - Management
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

• 102 AKI: Clinical, Outcomes, and Trials

Authors

• Kim, Minhyung, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)

Minhyung Kim, MD

• Song, Seungmin, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)

Seungmin Song, MD

• Lee, Kyungho, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)

Kyungho Lee, MD, PhD

• Lee, Jung eun, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)

Jung eun Lee, MD, PhD

• Huh, Wooseong, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)

Wooseong Huh, MD, PhD

• Jang, Hye Ryoun, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)

Hye Ryoun Jang, MD, PhD

• Jeon, Junseok, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)

Junseok Jeon, MD, PhD

Background

Sodium restriction can help prevent and alleviate congestion in patients with heart failure (HF), but the benefits of sodium restriction are controversial. Patients with worsening renal function (WRF) during treatment of heart failure have worse outcomes and may benefit from more strict volume control. We investigated the prognostic impact of sodium restriction in patients hospitalized with HF focusing on WRF.

Methods

This retrospective cohort study included patients hospitalized for HF from 2000 to 2019. WRF was defined as a decrease in estimated glomerular filtration rate (eGFR) >20% from admission at any point during hospitalization. The difference in weight from admission to discharge was used to estimate the degree of decongestion. Low-sodium diet status was estimated from the diet prescription at the time of discharge. The primary outcome was all-cause mortality.

Results

In a total of 1,079 patients, 566 (52.5%) developed WRF and 325 (30.1%) consumed a low-sodium diet. There was no difference in baseline characteristics between the low-sodium diet and control groups, except for eGFR (low-sodium diet vs control: 58 vs 66 mL/min/1.73 m²; p=0.001). The proportion of low-sodium diets did not differ between the WRF and no-WRF groups (31% vs 29%; p=0.548). The low-sodium diet group lost more weight than the control group (-2.2 vs -1.9 kg; p=0.015) during hospitalization. During a median follow-up of 33.1 months (IQR 4.7–64.5), 229 (21.2%) patients died. Low-sodium diet was associated with lower mortality in the WRF group (HR 0.563, 95% CI 0.385–0.822, p=0.003), but not in the no-WRF group (HR 0.922, 95% CI 0.563–1.510, p=0.747). Low-sodium diet showed association with lower mortality after multivariable adjustment in the WRF group (adjusted HR 0.668, 95% CI 0.452-0.987, p=0.043).

Conclusion

Low-sodium diet could be beneficial for patient with HF requiring hospitalization, especially with WRF.