Lower urine sodium predicts longer length of stay in acute heart failure patients: Insights from the ROSE AHF trial

Abstract

Background: In patients hospitalized with acute heart failure (AHF), low urine sodium concentration (UNa) after diuretic treatment may identify patients at risk for longer length of stay (LOS) and adverse events. We investigated the prognostic significance of 24-hour cumulative postdiuretic urine sodium concentration in a multicenter clinical trial population. Methods: The Renal Optimization Strategies Evaluation AHF (ROSE AHF) trial randomized 360 patients with AHF and renal dysfunction receiving intravenous diuretic to dopamine, nesiritide, or placebo. Sodium concentration was measured in cumulative urine sample collected during the first 24 hours after randomization in 298 patients. Based on prior studies, lower UNa was defined as ≤60 mmol/L. Results: Lower UNa was present in 142 (48%) patients, who had longer LOS (7 days vs 5 days, P