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27.02.2024 | Review

Evaluation and Management of Hyponatremia in Heart Failure

verfasst von: Giulio M. Mondellini, Frederik H. Verbrugge

Erschienen in: Current Heart Failure Reports

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Abstract

Purpose of Review

To provide a contemporary overview of the pathophysiology, evaluation, and treatment of hyponatremia in heart failure (HF).

Recent Findings

Potassium and magnesium losses due to poor nutritional intake and treatment with diuretics cause an intracellular sodium shift in HF that may contribute to hyponatremia. Impaired renal blood flow leading to a lower glomerular filtration rate and increased proximal tubular reabsorption lead to an impaired tubular flux through diluting distal segments of the nephron, compromising electrolyte-free water excretion.

Summary

Hyponatremia in HF is typically a condition of impaired water excretion by the kidneys on a background of potassium and magnesium depletion. While those cations can and should be easily repleted, further treatment should mainly focus on improving the underlying HF and hemodynamics, while addressing congestion. For decongestive treatment, proximally acting diuretics such as sodium-glucose co-transporter-2 inhibitors, acetazolamide, and loop diuretics are the preferred options.
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Metadaten
Titel
Evaluation and Management of Hyponatremia in Heart Failure
verfasst von
Giulio M. Mondellini
Frederik H. Verbrugge
Publikationsdatum
27.02.2024
Verlag
Springer US
Erschienen in
Current Heart Failure Reports
Print ISSN: 1546-9530
Elektronische ISSN: 1546-9549
DOI
https://doi.org/10.1007/s11897-024-00651-3

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