title: Identifying predictors of high sodium excretion in patients with heart failure: a mixed effect analysis of longitudinal data.
abstract: BACKGROUND
  A low-sodium diet is a core component of heart failure self-care but patients have difficulty following the diet.
  
  
  OBJECTIVE
  The aim of this study was to identify predictors of higher than recommended sodium excretion among patients with heart failure.
  
  
  METHODS
  The World Health Organization Five Dimensions of Adherence model was used to guide analysis of existing data collected from a prospective, longitudinal study of 280 community-dwelling adults with previously or currently symptomatic heart failure. Sodium excretion was measured objectively using 24-hour urine sodium measured at three time points over six months. A mixed effect logistic model identified predictors of higher than recommended sodium excretion.
  
  
  RESULTS
  The adjusted odds of higher sodium excretion were 2.90, (95% confidence interval (CI): 1.15-4.25, p<0.001) for patients who were obese; 2.80 (95% CI: 1.33-5.89, p=0.007) for patients with diabetes; and 2.22 (95% CI: 1.09-4.53, p=0.028) for patients who were cognitively intact.
  
  
  CONCLUSIONS
  Three factors were associated with excess sodium excretion and two factors, obesity and diabetes, are modifiable by changing dietary food patterns.
authors.affiliation: School of Nursing, University of Pennsylvania USA rumaster@nursing.upenn.edu.
authors.forename: Ruth
authors.initials: R
authors.lastname: Masterson Creber
authors.affiliation: School of Nursing, University of Pennsylvania USA.
authors.forename: Maxim
authors.initials: M
authors.lastname: Topaz
authors.affiliation: College of Nursing, University of Kentucky, USA.
authors.forename: Terry A
authors.initials: TA
authors.lastname: Lennie
authors.affiliation: Oregon Health & Science University, Portland, USA.
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Lee
authors.affiliation: Department of Biobehavioral Health Science, University of Illinois at Chicago, USA.
authors.forename: Houry
authors.initials: H
authors.lastname: Puzantian
authors.affiliation: School of Nursing, University of Pennsylvania USA.
authors.forename: Barbara
authors.initials: B
authors.lastname: Riegel
mesh_terms: D000368:Aged; D015331:Cohort Studies; D016001:Confidence Intervals; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology; D004039:Diet, Sodium-Restricted; D018572:Disease-Free Survival; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000178:diet therapy* / Q000401:mortality*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology; D016017:Odds Ratio; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010353:Patient Education as Topic; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012982:Sodium, Dietary / Q000592:standards / Q000652:urine*; D013223:Statistics as Topic; D016019:Survival Analysis; D016482:Urinalysis; D014944:World Health Organization
chemical_list: D012982:Sodium, Dietary
keywords: Heart failure; diet; diet therapy; sodium-restricted; urine sodium