Meta analysis on sodium restriction in heart failure patients


(Laurie Bilyeu) #1

Interested in the study reviewed here: https://www.medpagetoday.com/cardiology/chf/76138

According to this one, we also aren’t basing our recommendations about sodium restriction in congestive heart failure on RCTs but on “expert consensus.” Sigh.

I’m a dietitian. I work with the elderly. Lots of heart failure. Banging my head on the desk.


(Candy Lind) #2

Aren’t we ALL!!?? :woman_facepalming:


(Bob M) #3

Yeah, the RCTs with heart failure and salt are all over the map.

Look into correlations between insulin resistance and heart failure and ketones and heart failure sometime. IR is associated with heart failure, but of course treating IR is not something considered for treatment of heart failure. Also, a failing heart is known to prefer ketones, but we wouldn’t want to encourage people to go on diets that produce ketones, would we?


#4

Hmm, currently reading ‘The Salt Fix’, interesting reading!


(Laurie Bilyeu) #5

Right?
I will follow those leads, thank you. In the mean time, I’m sharing that study with the docs I work with. We have a patient who is very sick with CHF right now–Feeling sad that he may have gotten bad advice all this time. We actually might offer him the option of keto–he’d be a person who could do it if he chose to.


(Laurie Bilyeu) #6

Yep, just finished it myself. Made plenty of sense to me. He didn’t address CHF much, so I was wondering…and then this study hit my feed. I am also wondering if a higher sodium diet would help prevent chronic urinary tract infections in my frail elders.


(Kristin) #7

As a nurse who formerly worked on a cardiac floor with many CHF patients, I find this interesting.

Knowing now about keto, I’m thinking the diuretic nature of this woe would be beneficial for people with CHF.


(Laurie Bilyeu) #8

Kristin, I think I agree. What a position to be in, as a medical person who sees the treatment might be all wrong, but not be in a position to change it! And it will be a while before we can get saturated fat into a cardiac diet. Maybe there is a modified version I can promote sooner. Reduced carbs for the diuresis, but with eggs and avocados instead of bacon. Hmm.

I have started suggestion to my patients with edema that carbs may be “as much or more” to blame for water retention as sodium…