Introduction: The present study examined the possible estimation of plasma renin activity (PRA) by serum and urinary concentrations of chloride vs. sodium in acute and chronic heart failure (HF). Methods: Data from 29 patients with acute HF (48% men;80.3±12 years-old) and 26 patients with recovery of HF after decongestive therapy (50% men;81.2±12 years-old) were analyzed. Blood and urine samples were obtained immediately before decongestive therapy in acute HF patients. Clinical tests included peripheral blood tests, serum and spot urinary electrolytes, and plasma neurohormones. Sodium- or chloride-related indices included serum ([sNa+] or [sCl-]) and urinary ([uNa+] or [uCl-]) concentrations, their differences, and their ratio. Linear regression analysis was used for correlation coefficients. Results: PRA levels higher than the normal range were detected in only 5 (17%) of 29 patients with acute HF, but in as many as 11 (42%) of 26 patients with chronic HF. In the 29 patients with acute HF, all the chloride- and sodium-related indices except for [sNa+] were correlated with PRA: the [sCl-]/[uCl-] ratio were best correlated with PRA (R2=0.84, p<0.0001) followed by the [sNa+]/[uNa+] ratio (R2=0.64, p<0.0001). In the 26 patients with chronic HF, however, both the [sCl-] (R2=0.36, p=0.001) and [sNa+] (R2=0.22, p=0.016) were only weakly correlated with PRA. Conclusion: In acute HF, chloride-related indices derived from serum and urinary concentrations were firmly associated with PRA as well as or better than sodium-related indices. In chronic HF, neither chloride- nor sodium-related indices were not firmly associated with PRA, presumably due to influence of cardiovascular medication.


中文翻译：

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根据血清和尿液氯化物浓度与钠浓度估算血浆肾素活性

简介：本研究检查了在急性和慢性心力衰竭 (HF) 中通过血清和尿液氯化物浓度与钠浓度对血浆肾素活性 (PRA) 的可能估计。方法：分析了 29 名急性 HF 患者（48% 男性；80.3±12 岁）和 26 名经减充血治疗后恢复的 HF 患者（50% 男性；81.2±12 岁）的数据。在急性 HF 患者的减充血治疗前立即获得血液和尿液样本。临床测试包括​​外周血测试、血清和尿液电解质以及血浆神经激素。钠或氯相关指标包括血清（[sNa+] 或 [sCl-]）和尿液（[uNa+] 或 [uCl-]）浓度、它们的差异和比率。线性回归分析用于相关系数。结果：高于正常范围的 PRA 水平仅在 29 名急性 HF 患者中的 5 名 (17%) 中检测到，但在 26 名慢性 HF 患者中多达 11 名 (42%)。在 29 名急性 HF 患者中，除 [sNa+] 外，所有氯和钠相关指标均与 PRA 相关：[sCl-]/[uCl-] 比值与 PRA 的相关性最好（R2=0.84，p< 0.0001) 然后是 [sNa+]/[uNa+] 比值 (R2=0.64, p<0.0001)。然而，在 26 名慢性 HF 患者中，[sCl-] (R2=0.36, p=0.001) 和 [sNa+] (R2=0.22, p=0.016) 与 PRA 的相关性很弱。结论：在急性 HF 中，来自血清和尿液浓度的氯相关指标与 PRA 密切相关，甚至优于钠相关指标。在慢性 HF 中，无论是氯还是钠相关指标都与 PRA 不密切相关，