Evidence map›Paper›PMID 32086996›Full record

ArticleEuropean journal of heart failure2020

Clinical importance of urinary sodium excretion in acute heart failure.

Kevin Damman, Jozine M Ter Maaten, Jenifer E Coster, Jan A Krikken, Vincent M van Deursen, Hidde K Krijnen, Mischa Hofman, Wybe Nieuwland, Dirk J van Veldhuisen, Adriaan A Voors and 1 more

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In one paragraph

Article in European journal of heart failure, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
50citing papers in PubMed, 2 pooled it
8.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

50 citing papers in PubMed, 2 syntheses or guidelines pooled it, 99 citations in OpenAlex.

  1. Pooled it
  2. The value of urinary sodium assessment in acute heart failure.European heart journal. Acute cardiovascular care · 2021
    Pooled it
  3. Trial
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  8. Article
  9. Effects of natriuresis-guided diuretic therapy in men and women with acute heart failure: insights from PUSH-AHF.Clinical research in cardiology : official journal of the German Cardiac Society · 2026
    Article
  10. Review
  11. Observational
  12. Article
  13. Decongestion Strategies in Acute Heart Failure.Current heart failure reports · 2026
    Review
  14. Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 2 institutions in 1 country.

Kevin DammanUniversity of Groningen, Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands.
Jozine M Ter MaatenUniversity of Groningen, Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands.
Jenifer E CosterUniversity of Groningen, Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands.
Jan A KrikkenUniversity of Groningen, Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands.
Vincent M van DeursenUniversity of Groningen, Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands.
Hidde K KrijnenUniversity of Groningen, Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands.
Mischa HofmanUniversity of Groningen, Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands.
Wybe NieuwlandUniversity of Groningen, Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands.
Dirk J van VeldhuisenUniversity of Groningen, Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands.
Adriaan A VoorsUniversity of Groningen, Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands.
Peter van der MeerUniversity of Groningen, Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands.
University Medical Center Groningen · NLUniversity of Groningen · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsUrinary sodium assessment has recently been proposed as a target for loop diuretic therapy in acute heart failure (AHF). We aimed to investigate the time course, clinical correlates and prognostic importance of urinary sodium excretion in AHF. METHODS AND

resultsIn a prospective cohort of 175 consecutive patients with an admission for AHF we evaluated urinary sodium excretion 6 h after initiation of loop diuretic therapy. Clinical outcome was all-cause mortality or heart failure rehospitalization. Mean age was 71 ± 14 years, and 44% were female. Median urinary sodium excretion was 130 (67-229) mmol at 6 h, 347 (211-526) mmol at 24 h, and decreased from day 2 to day 4. Lower urinary sodium excretion was independently associated with male gender, younger age, renal dysfunction and pre-admission loop diuretic use. There was a strong association between urinary sodium excretion at 6 h and 24 h urine volume (beta = 0.702, P < 0.001). Urinary sodium excretion after 6 h was a strong predictor of all-cause mortality after a median follow-up of 257 days (hazard ratio 3.81, 95% confidence interval 1.92-7.57; P < 0.001 for the lowest vs. the highest tertile of urinary sodium excretion) independent of established risk factors and urinary volume. Urinary sodium excretion was not associated with heart failure rehospitalization.

conclusionIn a modern, unselected, contemporary AHF population, low urinary sodium excretion during the first 6 h after initiation of loop diuretic therapy is associated with lower urine output in the first day and independently associated with all-cause mortality.

Indexed as

Heart FailureAcute DiseaseAgedAged, 80 and overAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsFemaleHumansMaleMiddle AgedProspective StudiesSodiumStroke VolumeVentricular Function, LeftAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsSodiumAcute heart failureDiureticNatriuresisUrinary sodium

Identifiers

PMID32086996
PMCPMC7540361
OpenAlexW3008247739

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.