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Hyponatremia in Heart Failure

Ernest Gallo Distinguished Professor of Medicine

^* To whom correspondence should be addressed. E-mail: kanu-chatterjee{at}uiowa.edu.

	Abstract

Hyponatremia is one of the newer and emerging risk factors for an adverse prognosis in chronic heart failure. Why decreased serum sodium is associated with worse prognosis remains unclear. It may reflect worsening heart failure and the deleterious effects of activation of neurohormones. The mechanism of hyponatremia in heart failure also remains unclear. A relatively greater degree of free-water retention compared to sodium retention is probably the major mechanism. The treatment of significant hyponatremia in heart failure is difficult. The conventional treatments such as fluid restriction, infusion of hypertonic saline, and aggressive diuretic therapies are not usually effective. Vasopressin receptor antagonists have been shown to enhance aquaresis and correct hyponatremia. However, long-term beneficial effects of such treatments in chronic heart failure have not been documented.

First published on October 21, 2009, doi:10.1177/0885066609344941

Journal of Intensive Care Medicine 2009;24:347.

A more recent version of this article appeared on November 1, 2009


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