Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Cardiology

Background: Acute decompensated heart failure (ADHF) is a life-threatening disease requiring urgent treatment, including a recommendation for immediate initiation of loop diuretics. Loop diuretics are administered in up to 90% of patients hospitalized for acute decompensated heart failure, despite the lack of evidence for outcome benefit.Poor response to diuretic therapy frequently occurs in patients during hospitalization for acute heart failure, although the exact frequency is unknown owing to the lack of a standard definition. Objectives: to assess the predictive value of admission levels of urinary sodium potassium ratio on diuretic response within the first three days after hospital admission in ADHF patients. Patients and methods:This is a prospective study recruited 150 consecutive patients with ADHF NYHA class IV presenting to intensive care units of Cardiology Department in KasrElainy Hospital, Cairo University. Patients' age was more than 18 years. Spot urine levels of Na and K on admission and 3rd hospitalization day were performed. Timing of urine sample: Urinary samples was taken 6 hours after the 1st IV diuretic dose on admission day and on the 3rd hospitalization day was taken 6 hours after the morning diuretic dose

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