A systematic review of water and sodium restriction in improving cardiac function of people with heart failure
10.3760/cma.j.issn.1674-2907.2019.27.018
- VernacularTitle:水钠限制对心力衰竭患者心功能改善的系统评价
- Author:
Xiaohua XU
1
;
Ying LIN
;
Xinyue DONG
;
Xian ZHANG
Author Information
1. 复旦大学附属中山医院护理部,上海 200032
- Keywords:
Heart failure;
? Water and sodium restriction;
? Cardiac function;
? Systemic review
- From:
Chinese Journal of Modern Nursing
2019;25(27):3513-3518
- CountryChina
- Language:Chinese
-
Abstract:
Objective? Systematic review and meta-analysis were used to explore the effect of sodium and water restriction on improving cardiac function (symptom score of heart failure and B-type natriuretic peptide were used as evaluation indexes) in patients with heart failure. Methods? Pubmed,CIHNAL,Embase and other foreign language databases,as well as Wanfang,CNKI and other Chinese language databases were searched and studies of randomized controlled trials(RCT)applying sodium and water restriction in the improvement of cardiac function in patients with heart failure published by March 2019 were included for systematic review and meta-analysis. Results? A total of 12 English literatures were included,of which,5 were Grade A and 7 were Grade B for study quality. Meta-analysis based on the heart failure score with water and sodium restriction showed that the symptoms of heart failure patients with sodium restriction (≤1.5 g/d) were relieved more obviously than those with sodium restriction above that level or without sodium restriction [SMD=0.50, 95%CI=(0.16, 0.83)]; for those with the level of sodium restriction lower than 0.8-3.0 g/d combined with fluid restriction below 800-1 500 ml/d, compared with those who did not met the criteria or those without sodium restriction, the heart failure symptom scores decreased without significance [SMD=-0.18,95%CI=(-0.43,0.08)]. Moreover, in each study, B-type natriuretic peptide was mostly non-normal data, which was not suitable for Meta-analysis. Descriptive analysis showed that two studies showed that B-type natriuretic peptide could be significantly reduced under 2.3 g/d sodium restriction and 1 000 ml/d water restriction,respectively. The other studies had negative results in the studies of water and sodium restriction in changing B-type natriuretic peptide. Conclusions? The daily sodium restriction of 1.5 g has a significant effect on the improvement of cardiac function in patients with acute heart failure or edema symptoms. The daily sodium restriction of 1 000 ml has a significant effect on the improvement of cardiac function in patients with decompensated heart failure.
