Effects of hypertonic saline solution on body weight and serum creatinine in patients with acute decompensated heart failure

Table 1 Baseline characteristics of the study population n (%)

Variables	n = 47
Age (yr)	77.6 ± 9.5
Males	32 (68.1)
Body mass index (kg/m2)	28.2 ± 7.2
Hypertension	46 (97.9)
Diabetes	28 (59.6)
NYHA functional class (admission)
III	16 (38.1)
IV	23 (54.8)
Coronary artery disease	33 (70.2)
Ischemic heart failure	29 (61.7)
Stroke or transient ischemic attack	11 (23.4)
Vascular disease	22 (46.8)
Atrial fibrillation	27 (57.4)
Oxygen-dependent COPD	4 (8.5)
Active cancer	11 (23.4)
Baseline creatinine (µmol/L)1	140.1 ± 65.5
Chronic kidney disease (eGFR ≤ 60 mL/min per 1.73 m2)1	32 (68.1)
Admission creatinine (µmol/L)	154.8 ± 65.4
Admission eGFR using MDRD (mL/min per 1.73 m2)	42.2 ± 22.3
Admission serum Na concentration < 135 mmol/L	12 (25.5)
Echocardiographic data
Left ventricle ejection fraction	39.9 ± 17.4
LVEF > 40%	23 (48.9)
LVEF ≤ 40%	24 (51.0)
Severe aortic stenosis	1 (2.2)
Moderate and/or severe mitral regurgitation	16 (34.8)
Severe tricuspid regurgitation	6 (13.0)
Pulmonary hypertension ≥ 50 mmHg	19 (41.3)
Severe diastolic dysfunction	11 (23.9)
Right ventricular dysfunction/dilatation	28 (60.9)
Medications
ACEI/ARBs	28 (59.6)
Hydralazine	3 (6.4)
Beta-blocker	39 (83.0)
Diuretics
Oral furosemide	39 (83.0)
Thiazide	9 (19.1)
Spironolactone	8 (17.0)
Zaroxolyn	1 (2.1)
Furosemide dose per day (mg)	128.2 ± 106.7

¹Average of the five most recent creatinine values before hospitalization. Values are expressed as mean ± SD or n (%). NYHA: New York Heart Association; COPD: Chronic obstructive pulmonary disease; eGFR: Estimated glomerular filtration rate; MDRD: Modification of Diet in Renal Disease equation; LVEF: Left ventricle ejection fraction; ACEI: Angiotensin-converting-enzyme inhibitor; ARBs: Angiotensin II receptor blockers.

Table 2 Weight loss and creatinine change per day of treatment (n = 47)

Variable	mean ± SD	95%CI	P value
Weight loss (kg/d)
Standard treatment	-0.39 ± 1.02	(-0.77, -0.03)
Experimental treatment	-1.43 ± 1.43	(-1.86, -1.02)
Standard-experimental difference	0.80 ± 1.77	(0.15, 1.44)	0.0168
Change in creatinine (μmol/L per day)
Standard treatment	3.48 ± 9.89	(0.51, 6.68)
Experimental treatment	-0.69 ± 9.62	(-3.51, 2.00)
Standard-experimental difference	4.20 ± 14.25	(-0.49, 8.88)	0.331

Table 3 Weight loss and creatinine change per day of treatment in the impasse subgroup (n = 15)

Variable	mean ± SD	95%CI	P value
Weight loss (kg/d)
Standard treatment	0.25 ± 0.64	(-0.04, 0.58)
Experimental treatment	-1.20 ± 1.30	(-1.89, -0.57)
Standard-experimental difference	1.45 ± 1.65	(0.54, 2.36)	0.0026
Change in creatinine (μmol/L per day)
Standard treatment	7.33 ± 8.65	(3.01, 11.70)
Experimental treatment	-3.79 ± 11.34	(-10.41, 1.63)
Standard-experimental difference	11.13 ± 13.29	(3.77, 18.49)	0.008