Fractional excretion of uric acid as an alternative marker of low natriuresis


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Abstract

Topicality. Currently, it is difficult to determine the natriuresis in patients with CD (circulatory decompensation?), as direct determination of sodium does not reflect the true natriuresis in patients on diuretic therapy. Purpose of the study. Evaluation of natriuretic renal function in patients with systolic heart failure during period of circulatory decompensation. Materials and methods. The study was based on the data of Pavlovsk register (?). The study included 127 patients; mean age was 70 ± 11 years; 32% of patients had BMI greater than З0 kg / m2, 9% of patients had SBP below 110 mm Hg; 29% of patients had hemoglobin levels below 110 gIL, hyponatremia was observed in 9% of patients. EF less than 30% was observed in 32.8% of patients, tachycardia more 100 beats per minute - in 32% of cases, while heart rate above 1З0 beats per minute was registered in 2.2% of cases. The median of fluid retention was 7.4 liters, mode - 11 liters, while the mean urine output was 890 ± З20 ml. Definition of FE UA in daily urine and blood was performed at admission and 7 days using ELISA, with subsequent evaluation by formula. FE UA <12% was considered as natriuresis level less than З0 mmol/l per day. Results. Unlike natriuresis, FE UA levels exposed significant positive correlation (r = 0.28; P <0.05) between EF UA on admission and 7 days after. Evaluation of the effects of diuretics on EF UA and natriuresis had revealed that the higher dose of the diuretic leads to lower natriuresis; by contrast, EF UA had no statistically significant differences with baseline levels, that allows to conclude that diuretics have no significant effect on the excretion of uric acid. Conclusion. Definition of EF UA as an alternative marker of low natriuresis will allow to correct diuretic therapy in patients with cd, because EF UA is not dependent on the action of diuretics.

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References

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