HYPONATREMIC INCIDENCE BY THE TYPE OF DIURETICS AMONG PATIENTS WITH ACUTE HEART FAILURE IN MEDICAL WARD OF RSUP DR. HASAN SADIKIN BANDUNG

• Main Author: Kemala Dewi, Ardilla
• Format: Theses
• Language: Indonesia
• Online Access: https://digilib.itb.ac.id/gdl/view/37157
• Institution: Institut Teknologi Bandung

Diuretics are the basis for the treatment of acute heart failure and its use can cause various electrolyte disorders such as hyponatremia. However, in Indonesia there have been no studies of the incidence of hospital-acquired hyponatremia caused by diuretics in patients with acute heart failure. This study is a retrospective analytic study with cross-sectional design through the study of medical record data in patients with acute heart failure in the inpatient ward of RSUP Dr. Hasan Sadikin Bandung for the period 2014-2018. There were 36 research subjects who met the inclusion criteria with 20 patients (mean age 50.81 ± 20.494, 69.44% male) who showed the incidence of hyponatremia when hospitalized with a normonatremia condition at admission and all received loop diuretics (furosemide), and some are combined with a potassium-sparing diuretic (aldosterone antagonist), namely spironolactone. Based on descriptive statistics on age variables, there are three outliers data that were not included in the relationship analysis using logistic regression. Relationship analysis at ?level of 5% (95% confidence level) on variables of sex, age, dose strength furosemide, spironolactone, concurrent therapy used, and diuresis factor showed that, the dose strength of furosemide (p-value 0.041<0.05; OR 12.066) and age (p-value 0.041<0.05; OR 0.921) significantly affected the incidence of hyponatremia. Hyponatremia based on biochemical severity was categorized as mild (61.11%, 11 patients), moderate (38.89%, 7 patients), and severe (0%). Hyponatremia based on the time of development of events was categorized as acute (<48 hours) (38.89%, 7 patients) and chronic (?48 hours) (61.11%, 11 patients). No patients showed symptoms of hyponatremia. It is concluded that elderly acute heart failure patients given high-dose furosemide with risk factors for female gender, comorbid renal impairment, and concomitant use of antihypertensive (ACEI groups) associated with the incidence of hyponatremia. So, it is recommended to check sodium levels for elderly patients with high-dose furosemide therapy that has risk factors.