{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T08:12:35Z","timestamp":1791360755791,"version":"4.3.1"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2019,2,17]],"date-time":"2019-02-17T00:00:00Z","timestamp":1550361600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"},{"start":{"date-parts":[[2019,2,17]],"date-time":"2019-02-17T00:00:00Z","timestamp":1550361600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Department of Heart Diseases, Wroclaw Medical University, Poland","award":["ST-905"],"award-info":[{"award-number":["ST-905"]}]},{"name":"Department of Heart Diseases, Wroclaw Medical University, Poland","award":["ST-905"],"award-info":[{"award-number":["ST-905"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The clinical significance of the measurement of urine sodium concentration (UNa+) in response to loop diuretic administration in patients with acute heart failure (AHF) is still unsettled. We studied the association of serial measurements of spot UNa+ during the first 48\u2009h of AHF treatment with the indices of decongestion, renal function, and prognosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We enrolled 111 AHF patients, all of whom received intravenous furosemide on admission. The mean spot UNa+ significantly increased in the 6\u2009h sample (P &amp;lt;\u20090.05 vs. baseline) and returned to baseline values in the 24 and 48\u2009h samples. Based on the increase or decrease\/no change of UNa+ in the 6 and 48\u2009h samples vs. baseline, patients were divided into two groups at each time point, respectively. Patients did not differ in baseline clinical and laboratory characteristics. Patients with a decrease\/no change of UNa+ in the 6 and 48\u2009h samples had a lower weight loss during hospitalization. Patients with a decrease\/no change of UNa+ in the 48\u2009h sample had a poorer diuretic response and a significant increase in the urinary levels of the tubular biomarkers: kidney injury molecule-1 and neutrophil gelatinase-associated lipocalin. Low UNa+ and decrease\/no change in UNa+ in the 6 and 48\u2009h samples were independent predictors of higher risk of all-cause mortality during 1-year follow-up (all P &amp;lt;\u20090.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In AHF, low spot UNa+ and lack to increase UNa+ in response to intravenous diuretics are associated with poor diuretic response, markers of tubular injury and high risk of 1-year mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.1428","type":"journal-article","created":{"date-parts":[[2019,2,18]],"date-time":"2019-02-18T00:38:35Z","timestamp":1550450315000},"page":"624-633","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":110,"title":["Serial Assessment of Spot Urine Sodium Predicts Effectiveness of Decongestion and Outcome in Patients with Acute Heart Failure"],"prefix":"10.1093","volume":"21","author":[{"given":"Jan","family":"Biegus","sequence":"first","affiliation":[{"name":"Centre for Heart Diseases, Military Hospital , Wroclaw ,","place":["Poland"]},{"name":"Department of Heart Diseases, Medical University , Wroclaw ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Zymli\u0144ski","sequence":"additional","affiliation":[{"name":"Centre for Heart Diseases, Military Hospital , Wroclaw ,","place":["Poland"]},{"name":"Department of Heart Diseases, Medical University , Wroclaw ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mateusz","family":"Sokolski","sequence":"additional","affiliation":[{"name":"Centre for Heart Diseases, Military Hospital , Wroclaw ,","place":["Poland"]},{"name":"Department of Heart Diseases, Medical University , Wroclaw ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Todd","sequence":"additional","affiliation":[{"name":"Singulex, Inc. , Alameda, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gad","family":"Cotter","sequence":"additional","affiliation":[{"name":"Momentum Research Inc. , Durham, NC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Metra","sequence":"additional","affiliation":[{"name":"Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia , Brescia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewa A.","family":"Jankowska","sequence":"additional","affiliation":[{"name":"Centre for Heart Diseases, Military Hospital , Wroclaw ,","place":["Poland"]},{"name":"Department of Heart Diseases, Medical University , Wroclaw ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waldemar","family":"Banasiak","sequence":"additional","affiliation":[{"name":"Centre for Heart Diseases, Military Hospital , Wroclaw ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Ponikowski","sequence":"additional","affiliation":[{"name":"Centre for Heart Diseases, Military Hospital , Wroclaw ,","place":["Poland"]},{"name":"Department of Heart Diseases, Medical University , Wroclaw ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,2,17]]},"reference":[{"key":"2026011721302760400_ejhf1428-bib-0001","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/j.ahj.2004.08.005","article-title":"ADHERE Scientific Advisory Committee and Investigators. Characteristics and outcomes of patients hospitalized for heart failure in the United States: rationale, design, and preliminary observations from the first 100,000 cases in the Acute Decompensated Heart Failure National Registry (ADHERE)","volume":"149","author":"Adams","year":"2005","journal-title":"Am Heart J"},{"key":"2026011721302760400_ejhf1428-bib-0002","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1016\/S0195-668X(02)00823-0","article-title":"Study Group on Diagnosis of the Working Group on Heart Failure of the European Society of Cardiology. The EuroHeart Failure survey programme \u2013 a survey on the quality of care among patients with heart failure in Europe Part 1: patient characteristics and diagnosis","volume":"24","author":"Cleland","year":"2003","journal-title":"Eur Heart J"},{"key":"2026011721302760400_ejhf1428-bib-0003","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/j.cardfail.2004.08.160","article-title":"Demographics, clinical characteristics, and outcomes of patients hospitalized for decompensated heart failure: observations from the IMPACT-HF registry","volume":"11","author":"O'Connor","year":"2005","journal-title":"J Card Fail"},{"key":"2026011721302760400_ejhf1428-bib-0004","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1093\/eurjhf\/hfq045","article-title":"Assessing and grading congestion in acute heart failure: a scientific statement from the Acute Heart Failure Committee of the Heart Failure Association of the European Society of Cardiology and endorsed by the European Society of Intensive Care Medicine","volume":"12","author":"Gheorghiade","year":"2010","journal-title":"Eur J Heart Fail"},{"key":"2026011721302760400_ejhf1428-bib-0005","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1002\/ejhf.1050","article-title":"Acutely decompensated heart failure with preserved and reduced ejection fraction present with comparable haemodynamic congestion","volume":"20","author":"Van Aelst","year":"2018","journal-title":"Eur J Heart Fail"},{"key":"2026011721302760400_ejhf1428-bib-0006","doi-asserted-by":"crossref","first-page":"1242","DOI":"10.1002\/ejhf.890","article-title":"Clinical phenotypes and outcome of patients hospitalized for acute heart failure: the ESC Heart Failure Long-Term Registry","volume":"19","author":"Chioncel","year":"2017","journal-title":"Eur J Heart Fail"},{"key":"2026011721302760400_ejhf1428-bib-0007","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1002\/ejhf.74","article-title":"Decongestion in acute heart failure","volume":"16","author":"Mentz","year":"2014","journal-title":"Eur J Heart Fail"},{"key":"2026011721302760400_ejhf1428-bib-0008","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1016\/j.jacc.2014.11.025","article-title":"The pathophysiological role of interstitial sodium in heart failure","volume":"65","author":"Nijst","year":"2015","journal-title":"J Am Coll Cardiol"},{"key":"2026011721302760400_ejhf1428-bib-0009","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1159\/000047397","article-title":"Diuretic therapy and resistance in congestive heart failure","volume":"96","author":"Ellison","year":"2001","journal-title":"Cardiology"},{"key":"2026011721302760400_ejhf1428-bib-0010","doi-asserted-by":"crossref","first-page":"1064","DOI":"10.1016\/j.ejheart.2007.07.011","article-title":"Relation between dose of loop diuretics and outcomes in a heart failure population: results of the ESCAPE trial","volume":"9","author":"Hasselblad","year":"2007","journal-title":"Eur J Heart Fail"},{"key":"2026011721302760400_ejhf1428-bib-0011","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1002\/ejhf.462","article-title":"Loop diuretics, renal function and clinical outcome in patients with heart failure and reduced ejection fraction","volume":"18","author":"Damman","year":"2016","journal-title":"Eur J Heart Fail"},{"key":"2026011721302760400_ejhf1428-bib-0012","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.1002\/ejhf.839","article-title":"Dynamic changes and prognostic value of pulmonary congestion by lung ultrasound in acute and chronic heart failure: a systematic review","volume":"19","author":"Platz","year":"2017","journal-title":"Eur J Heart Fail"},{"key":"2026011721302760400_ejhf1428-bib-0013","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1002\/ejhf.872","article-title":"Organ dysfunction, injury and failure in acute heart failure: from pathophysiology to diagnosis and management. A review on behalf of the Acute Heart Failure Committee of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC)","volume":"19","author":"Harjola","year":"2017","journal-title":"Eur J Heart Fail"},{"key":"2026011721302760400_ejhf1428-bib-0014","doi-asserted-by":"crossref","first-page":"1148","DOI":"10.1002\/ejhf.1158","article-title":"Direct comparison of ultrafiltration to pharmacological decongestion in heart failure: a per-protocol analysis of CARRESS-HF","volume":"20","author":"Grodin","year":"2018","journal-title":"Eur J Heart Fail"},{"key":"2026011721302760400_ejhf1428-bib-0015","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1080\/AC.70.3.3080630","article-title":"Determinants and impact of the natriuretic response to diuretic therapy in heart failure with reduced ejection fraction and volume overload","volume":"70","author":"Verbrugge","year":"2015","journal-title":"Acta Cardiol"},{"key":"2026011721302760400_ejhf1428-bib-0016","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1161\/CIRCHEARTFAILURE.114.001377","article-title":"Urinary composition during decongestive treatment in heart failure with reduced ejection fraction","volume":"7","author":"Verbrugge","year":"2014","journal-title":"Circ Heart Fail"},{"key":"2026011721302760400_ejhf1428-bib-0017","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCHEARTFAILURE.115.002370","article-title":"Rapid and highly accurate prediction of poor loop diuretic natriuretic response in patients with heart failure","volume":"9","author":"Testani","year":"2016","journal-title":"Circ Heart Fail"},{"key":"2026011721302760400_ejhf1428-bib-0018","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.ijcard.2017.08.053","article-title":"Long-term prognostic significance of urinary sodium concentration in patients with acute heart failure","volume":"254","author":"Honda","year":"2018","journal-title":"Int J Cardiol"},{"key":"2026011721302760400_ejhf1428-bib-0019","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1751-7133.2008.00037.x","article-title":"Loop diuretics can cause clinical natriuretic failure: a prescription for volume expansion","volume":"15","author":"Ali","year":"2009","journal-title":"Congest Heart Fail"},{"key":"2026011721302760400_ejhf1428-bib-0020","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1016\/j.cardfail.2014.03.006","article-title":"Insufficient natiuretic response to continuous intravenous furosemide is associated with poor long-term outcomes in acute decompensated heart failure","volume":"20","author":"Singh","year":"2014","journal-title":"J Card Fail"},{"key":"2026011721302760400_ejhf1428-bib-0021","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1016\/j.cardfail.2018.01.009","article-title":"Spot urine sodium as triage for effective diuretic infusion in an ambulatory heart failure unit","volume":"24","author":"Brinkley","year":"2018","journal-title":"J Card Fail"},{"key":"2026011721302760400_ejhf1428-bib-0022","doi-asserted-by":"crossref","first-page":"2388","DOI":"10.1093\/eurheartj\/ehn309","article-title":"ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM)","volume":"29","author":"Dickstein","year":"2008","journal-title":"Eur Heart J"},{"key":"2026011721302760400_ejhf1428-bib-0023","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1093\/eurjhf\/hfs105","article-title":"ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC","volume":"14","author":"McMurray","year":"2012","journal-title":"Eur J Heart Fail"},{"key":"2026011721302760400_ejhf1428-bib-0024","doi-asserted-by":"crossref","first-page":"461","DOI":"10.7326\/0003-4819-130-6-199903160-00002","article-title":"A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation","volume":"130","author":"Levey","year":"1999","journal-title":"Ann Intern Med"},{"key":"2026011721302760400_ejhf1428-bib-0025","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1001\/jama.1976.03270060029022","article-title":"The FeNa test","volume":"236","author":"Espinel","year":"1976","journal-title":"JAMA"},{"key":"2026011721302760400_ejhf1428-bib-0026","doi-asserted-by":"crossref","first-page":"47","DOI":"10.7326\/0003-4819-89-1-47","article-title":"Urinary diagnostic indices in acute renal failure","volume":"89","author":"Miller","year":"1978","journal-title":"Ann Intern Med"},{"key":"2026011721302760400_ejhf1428-bib-0027","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1016\/j.jacc.2013.05.027","article-title":"Timing of hemoconcentration during treatment of acute decompensated heart failure and subsequent survival: importance of sustained decongestion","volume":"62","author":"Testani","year":"2013","journal-title":"J Am Coll Cardiol"},{"key":"2026011721302760400_ejhf1428-bib-0028","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1161\/CIRCHEARTFAILURE.111.963413","article-title":"Is worsening renal function an ominous prognostic sign in patients with acute heart failure?","volume":"5","author":"Metra","year":"2012","journal-title":"Circ Heart Fail"},{"key":"2026011721302760400_ejhf1428-bib-0029","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1093\/eurjhf\/hfr087","article-title":"Prognostic utility of plasma neutrophil gelatinase-associated lipocalin in patients with acute heart failure: the NGAL EvaLuation Along with B-type NaTriuretic Peptide in acutely decompensated heart failure (GALLANT) trial","volume":"13","author":"Maisel","year":"2011","journal-title":"Eur J Heart Fail"},{"key":"2026011721302760400_ejhf1428-bib-0030","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1093\/eurjhf\/hfq002","article-title":"Characteristics, outcomes, and predictors of mortality at 3 months and 1 year in patients hospitalized for acute heart failure","volume":"12","author":"Harjola","year":"2010","journal-title":"Eur J Heart Fail"},{"key":"2026011721302760400_ejhf1428-bib-0031","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1002\/ejhf.757","article-title":"Renal tubular resistance is the primary driver for loop diuretic resistance in acute heart failure","volume":"19","author":"ter Maaten","year":"2017","journal-title":"Eur J Heart Fail"},{"key":"2026011721302760400_ejhf1428-bib-0032","doi-asserted-by":"crossref","first-page":"1872","DOI":"10.1093\/eurheartj\/ehx035","article-title":"Renal sodium avidity in heart failure: from pathophysiology to treatment strategies","volume":"38","author":"Mullens","year":"2017","journal-title":"Eur Heart J"},{"key":"2026011721302760400_ejhf1428-bib-0033","doi-asserted-by":"crossref","first-page":"2223","DOI":"10.1046\/j.1523-1755.2002.00683.x","article-title":"Significance of the fractional excretion of urea in the differential diagnosis of acute renal failure","volume":"62","author":"Carvounis","year":"2002","journal-title":"Kidney Int"},{"key":"2026011721302760400_ejhf1428-bib-0034","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1016\/j.jacc.2013.11.053","article-title":"The global health and economic burden of hospitalizations for heart failure","volume":"63","author":"Ambrosy","year":"2014","journal-title":"J Am Coll Cardiol"}],"container-title":["European Journal of Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fejhf.1428","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ejhf.1428","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ejhf.1428","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/eurjhf\/article-pdf\/21\/5\/624\/66193077\/eurjhf_21_5_624.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurjhf\/article-pdf\/21\/5\/624\/66193077\/eurjhf_21_5_624.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T02:30:40Z","timestamp":1768703440000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurjhf\/article\/21\/5\/624\/8408054"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,17]]},"references-count":34,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2019,2,17]]},"published-print":{"date-parts":[[2019,5,1]]}},"URL":"https:\/\/doi.org\/10.1002\/ejhf.1428","relation":{},"ISSN":["1388-9842","1879-0844"],"issn-type":[{"value":"1388-9842","type":"print"},{"value":"1879-0844","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2019,5]]},"published":{"date-parts":[[2019,2,17]]},"assertion":[{"value":"2018-09-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-01-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-02-17","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}