Admission renal function and electrolyte levels for estimation of total diuretic dose in acute heart failure patients

Abstract

Heart failure is one of the major challenges in the healthcare system. Hospitalizations are a primary concern for these patients, imposing significant burdens on both the patients and the healthcare system. Identifying the factors that influence better management of these patients is crucial, as it can help reduce the overall disease burden. Typically, congestion is the primary issue in hospitalized heart failure patients, and the main treatment involves loop diuretics. Estimating the necessary diuretic dosage is important for better management of these patients. The aim of this study is to evaluate renal function and electrolyte levels at the time of admission to estimate the required diuretic dosage in patients hospitalized with acute heart failure. Methods and Materials: This study is a descriptive cross-sectional study with a prospective approach conducted in 2023. It included all patients diagnosed with acute heart failure who were admitted to Shahid Madani Hospital (affiliated with Tabriz University of Medical Sciences) through a complete census. All patient information, including age, gender, cause of heart failure, underlying conditions, medications used, laboratory findings, echocardiographic results, medications administered during hospitalization, and the total dose of furosemide administered, was recorded. The relationship between renal function and electrolyte levels at the time of admission with the total dose of furosemide prescribed during hospitalization was evaluated using regression methods, leveraging artificial intelligence and machine learning techniques. Results: In this study 250 patients with heart failure with mean age of 65/18±13.8 years and 65%of them were men. In these patients, the mean serum BUN level was 24/73±11/08 mg/dl and the mean total dose of furosemide was 540/88±223/46 mg. There was a significant relationship between BUN and the total dose of furosemide (P=0.033).