Role of Sodium and Sodium Restriction in Heart Failure.

Pieter Martens, W H Wilson Tang

Journal: Current heart failure reports 2023;20(3):230-236

PMID: 37227668

Abstract

PURPOSE OF REVIEW

Sodium plays an essential role in the regulation of extracellular volume. The current review discusses the physiologic handling of sodium in the body, underscores pathophysiologic alterations in sodium handling in heart failure and assesses the evidence and rational for sodium restriction in heart failure.

RECENT FINDINGS

Recent trials such as the SODIUM-HF trial have failed to demonstrate a benefit of sodium restriction in heart failure. The current review re-evaluates physiologic elements in sodium handling and discusses how the intrinsic renal sodium avidity, which drives the renal propensity towards retaining sodium, differs amongst patients. The sodium intake in heart failure patients is often above the threshold set by guidelines. This review gives an overview of the pathophysiology of sodium retention in heart failure and the rational for sodium restriction and potential of individualizing sodium restriction recommendations based on renal sodium avidity profiles.

Address: Kaufman Center for Heart Failure Treatment and Recovery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, 9500 Euclid Avenue, Desk J3-4, Cleveland, OH, 44195, USA. [email protected].; Kaufman Center for Heart Failure Treatment and Recovery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, 9500 Euclid Avenue, Desk J3-4, Cleveland, OH, 44195, USA.

DOI: 10.1007/s11897-023-00607-z