{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T17:24:35Z","timestamp":1791307475699,"version":"4.3.1"},"reference-count":50,"publisher":"Portland Press Ltd.","issue":"3","content-domain":{"domain":["portlandpress.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2008,2,1]]},"abstract":"<jats:p>The aim of the present study was to evaluate the effects of a normal-sodium (120\u00a0mmol sodium) diet compared with a low-sodium diet (80\u00a0mmol sodium) on readmissions for CHF (congestive heart failure) during 180\u00a0days of follow-up in compensated patients with CHF. A total of 232 compensated CHF patients (88 female and 144 male; New York Heart Association class II\u2013IV; 55\u201383\u00a0years of age, ejection fraction &amp;lt;35% and serum creatinine &amp;lt;2\u00a0mg\/dl) were randomized into two groups: group 1 contained 118 patients (45 females and 73 males) receiving a normal-sodium diet plus oral furosemide [250\u2013500\u00a0mg, b.i.d. (twice a day)]; and group 2 contained 114 patients (43 females and 71 males) receiving a low-sodium diet plus oral furosemide (250\u2013500\u00a0mg, b.i.d.). The treatment was given at 30\u00a0days after discharge and for 180\u00a0days, in association with a fluid intake of 1000\u00a0ml per day. Signs of CHF, body weight, blood pressure, heart rate, laboratory parameters, ECG, echocardiogram, levels of BNP (brain natriuretic peptide) and aldosterone levels, and PRA (plasma renin activity) were examined at baseline (30\u00a0days after discharge) and after 180\u00a0days. The normal-sodium group had a significant reduction (P&amp;lt;0.05) in readmissions. BNP values were lower in the normal-sodium group compared with the low sodium group (685\u00b1255 compared with 425\u00b1125 pg\/ml respectively; P&amp;lt;0.0001). Significant (P&amp;lt;0.0001) increases in aldosterone and PRA were observed in the low-sodium group during follow-up, whereas the normal-sodium group had a small significant reduction (P=0.039) in aldosterone levels and no significant difference in PRA. After 180\u00a0days of follow-up, aldosterone levels and PRA were significantly (P&amp;lt;0.0001) higher in the low-sodium group. The normal-sodium group had a lower incidence of rehospitalization during follow-up and a significant decrease in plasma BNP and aldosterone levels, and PRA. The results of the present study show that a normal-sodium diet improves outcome, and sodium depletion has detrimental renal and neurohormonal effects with worse clinical outcome in compensated CHF patients. Further studies are required to determine if this is due to a high dose of diuretic or the low-sodium diet.<\/jats:p>","DOI":"10.1042\/cs20070193","type":"journal-article","created":{"date-parts":[[2008,1,10]],"date-time":"2008-01-10T11:49:18Z","timestamp":1199965758000},"page":"221-230","update-policy":"https:\/\/doi.org\/10.1042\/crossmark_policy","source":"Crossref","is-referenced-by-count":195,"title":["Normal-sodium diet compared with low-sodium diet in compensated congestive heart failure: is sodium an old enemy or a new friend?"],"prefix":"10.1042","volume":"114","author":[{"given":"Salvatore","family":"Paterna","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, University of Palermo, Piazzale delle Cliniche 2, 90100 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parrinello","family":"Gaspare","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Palermo, Piazzale delle Cliniche 2, 90100 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Fasullo","sequence":"additional","affiliation":[{"name":"Division of Cardiology \u2018Paolo Borsellino\u2019, G.F. Ingrassia Hospital, Corso Calatafimi 1002, 90100 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo\u00a0M.","family":"Sarullo","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Buccheri La Ferla Hospital, Palermo, Via Messina Marine, 90100 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Di\u00a0Pasquale","sequence":"additional","affiliation":[{"name":"Division of Cardiology \u2018Paolo Borsellino\u2019, G.F. Ingrassia Hospital, Corso Calatafimi 1002, 90100 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"288","published-online":{"date-parts":[[2008,1,8]]},"reference":[{"key":"2021120120530186300_B1","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1093\/oxfordjournals.eurheartj.a015223","article-title":"The epidemiology of heart failure","volume":"18","author":"Cowie","year":"1997","journal-title":"Eur. Heart J."},{"key":"2021120120530186300_B2","doi-asserted-by":"crossref","first-page":"2764","DOI":"10.1161\/01.CIR.92.9.2764","article-title":"Guidelines for the evaluation and management of heart failure","volume":"92","author":"American Heart Association Task Force on Practice Guidelines","year":"1995","journal-title":"Circulation"},{"key":"2021120120530186300_B3","first-page":"492","article-title":"Management of heart failure","volume-title":"Heart Disease: a Textbook of Cardiovascular Medicine","author":"Smith","year":"1997"},{"key":"2021120120530186300_B4","first-page":"219","article-title":"Tolerability and efficacy of high dose furosemide and small-volume hypertonic saline solution in refractory congestive heart failure","volume":"16","author":"Paterna","year":"1999","journal-title":"Adv. Therapy."},{"key":"2021120120530186300_B5","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/S0828-282X(07)70211-8","article-title":"Canadian Cardiovascular Society consensus conference: recommendations on heart failure update 2007: prevention management during intercurrent illness or acute decompensation and use of biomarkers","volume":"23","author":"Arnold","year":"2007","journal-title":"Can. J. Cardiol."},{"key":"2021120120530186300_B6","doi-asserted-by":"crossref","first-page":"9","DOI":"10.2165\/00044011-200019010-00002","article-title":"Small-volume hypertonic saline solution and high-dosage furosemide in the treatment of refractory congestive heart failure: a pilot study","volume":"19","author":"Paterna","year":"2000","journal-title":"Clin. Drug Invest."},{"key":"2021120120530186300_B7","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1016\/S1388-9842(00)00094-5","article-title":"Effects of high-dose furosemide and small-volume hypertonic saline solution infusion in comparison with a high dose of furosemide as a bolus, in refractory congestive heart failure","volume":"2","author":"Paterna","year":"2000","journal-title":"Eur. J. Heart Failure"},{"key":"2021120120530186300_B8","doi-asserted-by":"crossref","first-page":"165","DOI":"10.2165\/00044011-200525030-00002","article-title":"High-dose torasemide is equivalent to high-dose furosemide with hypertonic saline in the treatment of refractory congestive heart failure","volume":"25","author":"Paterna","year":"2005","journal-title":"Clin. Drug Invest."},{"key":"2021120120530186300_B9","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1067\/mhj.2003.166","article-title":"Effects of high-dose furosemide and small-volume hypertonic saline solution in comparison with a high dose of furosemide as bolus in refractory congestive heart failure: long term effects","volume":"145","author":"Licata","year":"2003","journal-title":"Am. Heart J."},{"key":"2021120120530186300_B10","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1067\/mhj.2003.165","article-title":"Hypertonic saline: A novel therapy for advanced heart failure?","volume":"145","author":"Drazner","year":"2003","journal-title":"Am. Heart J."},{"key":"2021120120530186300_B11","doi-asserted-by":"crossref","first-page":"1997","DOI":"10.1016\/j.jacc.2005.01.059","article-title":"Changes in BNP levels and bioelectrical impedance measurements after treatment with high dose furosemide and hypertonic saline solution versus high dose of furosemide alone, in refractory congestive heart failure: a double blind study","volume":"45","author":"Paterna","year":"2005","journal-title":"J. Am. Coll. Cardiol."},{"key":"2021120120530186300_B12","doi-asserted-by":"crossref","first-page":"2004","DOI":"10.1016\/j.jacc.2005.03.028","article-title":"Torrent or torment from the tubules? challenge of the cardiorenal connections","volume":"45","author":"Stevenson","year":"2005","journal-title":"J. Am. Coll. Cardiol."},{"key":"2021120120530186300_B13","doi-asserted-by":"crossref","first-page":"141G","DOI":"10.1016\/0002-9149(92)91262-3","article-title":"Management of refractory congestive heart failure","volume":"69","author":"Cody","year":"1992","journal-title":"Am. J. Cardiol."},{"key":"2021120120530186300_B14","first-page":"55","article-title":"Congestive heart failure: diagnosis, evaluation, and surgical therapy","volume-title":"Mayo Clinic Cardiology Review","author":"Rodeheffer","year":"2000"},{"key":"2021120120530186300_B15","first-page":"151","article-title":"Total and domestic consumption of salt and their determinants in three regions of Italy","volume":"45","author":"Leclercq","year":"1991","journal-title":"Eur. J. Clin. Nutr."},{"key":"2021120120530186300_B16","article-title":"Nutrient and energy intakes for the European Community","volume-title":"Reports of the Scientific Committee for Food, thirty-first series, Commission of the European Communities","author":"Scientific Committee for Food","year":"1993"},{"key":"2021120120530186300_B17","doi-asserted-by":"crossref","first-page":"132","DOI":"10.7326\/0003-4819-142-2-200501180-00013","article-title":"Pharmacotherapy for chronic heart failure: evidence from recent clinical trials","volume":"142","author":"Yan","year":"2005","journal-title":"Ann. Intern. Med."},{"key":"2021120120530186300_B18","first-page":"2996","article-title":"ACC\/AHA Guidelines for the evaluation and management of chronic heart failure in the adult: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines","volume":"104","author":"Hunt","year":"2001","journal-title":"Circulation"},{"key":"2021120120530186300_B19","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1001\/jama.287.5.628","article-title":"Medical management of advanced heart failure","volume":"287","author":"Nohria","year":"2002","journal-title":"JAMA, J. Am. Med. Assoc."},{"key":"2021120120530186300_B20","doi-asserted-by":"crossref","first-page":"F585","DOI":"10.1152\/ajprenal.2000.278.4.F585","article-title":"High dietary sodium chloride consumption may not induce body fluid retention in humans","volume":"278","author":"Heer","year":"2000","journal-title":"Am. J. Physiol. Renal Physiol."},{"key":"2021120120530186300_B21","doi-asserted-by":"crossref","first-page":"e7","DOI":"10.1016\/j.amjmed.2005.10.042","article-title":"Sodium intake and mortality in the NHANES II follow up study","volume":"119","author":"Cohen","year":"2006","journal-title":"Am. J. Med."},{"key":"2021120120530186300_B22","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1097\/HCO.0b013e32814f1d8c","article-title":"Salt, blood pressure and cardiovascular disease","volume":"22","author":"He","year":"2007","journal-title":"Curr. Opin. Cardiol."},{"key":"2021120120530186300_B23","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1136\/bmj.39147.604896.55","article-title":"Long term effects of dietary sodium reduction on cardiovascular disease outcomes: observational follow-up of the trials of hypertension prevention (TOHP)","volume":"334","author":"Cook","year":"2007","journal-title":"Br. Med. J."},{"key":"2021120120530186300_B24","first-page":"223","article-title":"A method for the detection and quantification of impaired sodium excretion","volume":"32","author":"Braunwald","year":"1965","journal-title":"Results of an oral sodium tolerance test in normal subjects and in patients with heart disease. Circulation"},{"key":"2021120120530186300_B25","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1172\/JCI112456","article-title":"Sodium and water balance in chronic congestive heart failure","volume":"77","author":"Cody","year":"1986","journal-title":"J. Clin. Invest."},{"key":"2021120120530186300_B26","doi-asserted-by":"crossref","first-page":"970","DOI":"10.1172\/JCI103357","article-title":"The relationship of cardiovascular and renal hemodynamic function to sodium excretion in patients with severe heart disease but without edema","volume":"35","author":"Hollander","year":"1956","journal-title":"J. Clin. Invest."},{"key":"2021120120530186300_B27","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1016\/S0002-8703(42)90299-0","article-title":"The effects of the ingestion of excessive amounts of sodium chloride and water on patients with heart disease","volume":"23","author":"Proger","year":"1942","journal-title":"Am. Heart. J."},{"key":"2021120120530186300_B28","doi-asserted-by":"crossref","first-page":"1620","DOI":"10.1161\/01.CIR.88.4.1620","article-title":"Abnormalities of sodium handling and of cardiovascular adaptations during high salt diet in patients with mild heart failure","volume":"88","author":"Volpe","year":"1993","journal-title":"Circulation"},{"key":"2021120120530186300_B29","doi-asserted-by":"crossref","first-page":"2505","DOI":"10.1210\/endo.134.6.8194476","article-title":"Brain natriuretic peptide in plasma, atria, and ventricles of vaspressin-and phenylephrine-infused conscious rats","volume":"134","author":"Magga","year":"1994","journal-title":"Endocrinology"},{"key":"2021120120530186300_B30","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1016\/j.ejheart.2005.01.004","article-title":"Design of therapy for advanced heart failure","volume":"7","author":"Stevenson","year":"2005","journal-title":"Eur. J. Heart Failure"},{"key":"2021120120530186300_B31","doi-asserted-by":"crossref","first-page":"1886","DOI":"10.1161\/01.CIR.94.8.1886","article-title":"Evidence for the existence of a functional cardiac renin angiotensin system in humans","volume":"94","author":"Neri\u00a0Serneri","year":"1996","journal-title":"Circulation"},{"key":"2021120120530186300_B32","doi-asserted-by":"crossref","first-page":"1847","DOI":"10.1161\/01.CIR.96.6.1847","article-title":"Direct vascular effects of furosemide in humans","volume":"96","author":"Pickkers","year":"1997","journal-title":"Circulation"},{"key":"2021120120530186300_B33","doi-asserted-by":"crossref","first-page":"R459","DOI":"10.1152\/ajpregu.2001.281.2.R459","article-title":"Neuroendocrine and renal effects of intravascular volume expansion in compensated heart failure","volume":"281","author":"Gabrielsen","year":"2001","journal-title":"Am. J. Physiol. Regul. Integr. Comp. Physiol."},{"key":"2021120120530186300_B34","doi-asserted-by":"crossref","first-page":"R1294","DOI":"10.1152\/ajpregu.00738.2005","article-title":"Hemodynamic and neuroendocrine responses to changes in sodium intake in compensated heart failure","volume":"290","author":"Damgaard","year":"2006","journal-title":"Am. J. Physiol. Regul. Integr. Comp. Physiol."},{"key":"2021120120530186300_B35","first-page":"R263","article-title":"Juxtaglomerular cell complex in the regulation of renal salt excretion","volume":"274","author":"Schnermann","year":"1998","journal-title":"Am. J. Physiol."},{"key":"2021120120530186300_B36","first-page":"64","article-title":"Interaction of prostaglandins and angiotensin II in the modulation of renal function in congestive heart failure","volume":"77","author":"Packer","year":"1988","journal-title":"Circulation"},{"key":"2021120120530186300_B37","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1016\/0002-9343(91)90631-7","article-title":"Effects of acetylsalicylic acid on renal function in patients with chronic heart failure","volume":"90","author":"Riegger","year":"1991","journal-title":"Am. J. Med."},{"key":"2021120120530186300_B38","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/S0002-8703(99)70113-4","article-title":"Aggravated renal dysfunction during intensive therapy for advanced chronic heart failure","volume":"138","author":"Weinfeld","year":"1999","journal-title":"Am. Heart J."},{"key":"2021120120530186300_B39","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1054\/jcaf.2002.125289","article-title":"The prognostic importance of different definitions of worsening renal function in congestive heart failure","volume":"8","author":"Gottlieb","year":"2002","journal-title":"J. Card. Failure"},{"key":"2021120120530186300_B40","doi-asserted-by":"crossref","first-page":"485","DOI":"10.3949\/ccjm.73.5.485","article-title":"Addressing the challenges of cardiorenal syndrome","volume":"73","author":"Geisberg","year":"2006","journal-title":"Clev. Clin. J. Med."},{"key":"2021120120530186300_B41","doi-asserted-by":"crossref","first-page":"F11","DOI":"10.1152\/ajprenal.00119.2002","article-title":"Loop diuretics: from the Na-K-2Cl transporter to clinical use","volume":"284","author":"Shankar","year":"2003","journal-title":"Am. J. Physiol. Renal. Physiol."},{"key":"2021120120530186300_B42","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1161\/01.CIR.73.2.257","article-title":"Prognostic importance of serum sodium concentration and its modification by converting-enzyme inhibition in patients with severe chronic heart failure","volume":"73","author":"Lee","year":"1986","journal-title":"Circulation"},{"key":"2021120120530186300_B43","doi-asserted-by":"crossref","first-page":"2454","DOI":"10.1161\/01.CIR.0000165065.82609.3D","article-title":"Lower serum sodium is associated with increased short-term mortality in hospitalized patients with worsening heart failure. Results from the Outcomes of a Prospective Trial of Intravenous Milrinone for Exacerbations of Chronic Heart Failure (OPTIME-CHF) study","volume":"111","author":"Klein","year":"2005","journal-title":"Circulation"},{"key":"2021120120530186300_B44","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1056\/NEJM197305242882102","article-title":"Renal and extrarenal hemodynamic effects of furosemide in congestive heart failure after acute myocardial infarction","volume":"288","author":"Dikshit","year":"1973","journal-title":"N. Engl. J. Med."},{"key":"2021120120530186300_B45","author":"Reference deleted"},{"key":"2021120120530186300_B46","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1056\/NEJM199908193410806","article-title":"Hormones and hemodynamics in heart failure","volume":"341","author":"Schrier","year":"1999","journal-title":"N. Engl. J. Med."},{"key":"2021120120530186300_B47","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/0140-6736(92)90405-R","article-title":"Pathophysiology of chronic heart failure","volume":"340","author":"Packer","year":"1992","journal-title":"Lancet"},{"key":"2021120120530186300_B48","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1172\/JCI108108","article-title":"Evidence for an in vivo antagonism between vasopressin and prostaglandin in the mammalian kidney","volume":"56","author":"Anderson","year":"1975","journal-title":"J. Clin. Invest."},{"key":"2021120120530186300_B49","first-page":"93\u201398","article-title":"Novel strategies: challenge loop diuretics and sodium management in heart failure \u2013 part I","volume":"13","author":"Di\u00a0Pasquale","year":"2007","journal-title":"Congest. Heart Failure"},{"key":"2021120120530186300_B50","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1111\/j.1527-5299.2007.06534.x","article-title":"Novel strategies: challenge loop diuretics and sodium management in heart failure \u2013 part II","volume":"13","author":"Di\u00a0Pasquale","year":"2007","journal-title":"Congest. Heart Failure"}],"updated-by":[{"DOI":"10.1042\/cs-20070193_eoc","type":"expression_of_concern","label":"Expression of concern","source":"retraction-watch","updated":{"date-parts":[[2020,7,17]],"date-time":"2020-07-17T00:00:00Z","timestamp":1594944000000},"record-id":"23813"},{"DOI":"10.1042\/cs-20070193_eoc","type":"expression_of_concern","label":"Expression of concern","source":"publisher","updated":{"date-parts":[[2020,7,17]],"date-time":"2020-07-17T00:00:00Z","timestamp":1594944000000}}],"container-title":["Clinical Science"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/portlandpress.com\/clinsci\/article-pdf\/114\/3\/221\/438775\/cs1140221.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/portlandpress.com\/clinsci\/article-pdf\/114\/3\/221\/438775\/cs1140221.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T17:08:23Z","timestamp":1638378503000},"score":1,"resource":{"primary":{"URL":"https:\/\/portlandpress.com\/clinsci\/article\/114\/3\/221\/68509\/Normal-sodium-diet-compared-with-low-sodium-diet"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,1,8]]},"references-count":50,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2008,2,1]]}},"URL":"https:\/\/doi.org\/10.1042\/cs20070193","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.1099373.555617","asserted-by":"object"}]},"ISSN":["0143-5221","1470-8736"],"issn-type":[{"value":"0143-5221","type":"print"},{"value":"1470-8736","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,1,8]]}}}