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Inicio Medicina Clínica (English Edition) Effectiveness of urea administration for the treatment of hyponatremia in heart ...
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Vol. 162. Issue 2.
Pages 56-59 (January 2024)
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Vol. 162. Issue 2.
Pages 56-59 (January 2024)
Original article
Effectiveness of urea administration for the treatment of hyponatremia in heart failure
Efectividad de la administración de urea para el tratamiento de la hiponatremia en la insuficiencia cardiaca
Ángel Martínez Gonzáleza,
Corresponding author
angelmg88@hotmail.com

Corresponding author.
, Pedro Rodeiro Escobarb, José Llópiz Castedob, María Díaz Vázquezb, Flor de Lis Sánchez Juanasb, María Villar Carballob, Marina Jara López Riberab, Manuella González Nunesc, Samuel Rodríguez Zorrillad, Avelino Rodríguez Gonzáleze
a Servicio de Endocrinología y Nutrición, Hospital Montecelo, Pontevedra, Spain
b Servició de Medicina Familiar y Comunitaria, Área Sanitaria de Vigo, Vigo, Pontevedra, Spain
c Enfermería, Hospital Montecelo, Pontevedra, Spain
d Departamento de Medicina Oral, Cirugía Oral e Implantología. Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
e Servicio de Medicina Interna, Hospital Álvaro Cunqueiro, Vigo, Pontevedra, Spain
Article information
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Figures (1)
Tables (3)
Table 1. Baseline general patient characteristics.
Table 2. Changes in laboratory parameters.
Table 3. Adverse effects of urea.
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Abstract
Objectives

To assess the efficacy and safety of urea in patients with hyponatremia and heart failure (HF).

Methods and results

This is a retrospective observational analytical study of patients with HF and hyponatremia (Na+ <135 mmol/l). Forty-nine patients treated with urea and 47 patients who did not receive urea, all under standard treatment (according to usual clinical practice) for HF, were included and followed up at Álvaro Cunqueiro Hospital in Vigo between January 2013 and May 2022. The study evaluated the normalization of sodium levels (Na > 135 mmol/l). The initial natremia at the start of oral urea treatment was 127 ± 5.22 mmol/l, at 24 h the sodium level was 128 ± 2.47 (p < 0.009), and the mean on the day of normalization was 135.19 ± 4.23 mmol/l (p < 0.005). The average number of days to achieve sodium normalization was 5.03 ± 2.37 days. The initial uremia at the start of urea treatment was 73 ± 46.93 mg/dl, and the mean on the day of Na + normalization was 116.05 ± 63.64 mg/dl (p < 0.002). The average oral urea dose was 22.5 g/day. No relevant adverse effects were observed, nor were there significant changes in creatinine levels.

Conclusions

Oral urea treatment, when added to standard treatment for short periods of time, is safe and effective in correcting natremia in patients with hypervolemic HF with hyponatremia.

Keywords:
Heart failure
Hyponatremia
Urea
Hypervolemia
Resumen
Objetivos

Valorar la eficacia y la seguridad de la urea en pacientes con hiponatremia e Insuficiencia cardiaca (IC).

Metodos y resultados

Se trata de un estudio observacional retrospectivo analitico de pacientes con IC e hiponatremia (Na+ <135 mmol/l). Se incluyeron 49 pacientes tratados con urea y 47 pacientes que no recibieron urea, todos ellos bajo tratamiento estándar (según práctica clínica habitual) de la IC, con seguimiento en el Hospital Álvaro Cunqueiro de Vigo entre enero de 2013 y mayo de 2022. En el estudio se evaluó la normalización de los niveles de sodio (Na > 135 mmol/l). La natremia al inicio del tratamiento con urea oral era de 127 ± 5.22 mmol/l, a las 24 horas el sodio era 128 ± 2,47 (p < 0,009) y la media el día de la normalización fue de 135,19 ± 4.23 mmol/l (p < 0,005). Los días de media para conseguir la normalización del sodio fueron 5,03 ± 2.37días. La uremia al inicio del tratamiento con urea era de 73 ± 46.93 mg/dl y la media el día de la normalización del Na + fue de 116.05 ± 63.64 mg/dl (p < 0.002). La dosis media de urea oral fue 22.5 g/día. No se observaron efectos adversos relevantes, ni cambios en cuanto a las cifras de creatinina.

Conclusiones

El tratamiento con urea oral añadido al tratatamiento estándar, durante cortos periodos de tiempo, es seguro y eficaz para corregir la natremia en pacientes con IC hipervolémica con hiponatremia.

Palabras clave:
Insuficiencia cardiaca
Hiponatremia
Urea
Hipervolemia

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