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Comment & Response |

Sodium and Fluid Restriction:  The Impact of Quality of Data and Reporting on the Conclusion

James Song-Jeng Yeh, MD1,2; Priyank Jain, MD1
[+] Author Affiliations
1Department of Internal Medicine, Cambridge Health Alliance, Cambridge, Massachusetts
2Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
JAMA Intern Med. 2014;174(1):162-163. doi:10.1001/jamainternmed.2013.11103.
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To the Editor We read with interest the recent article by Aliti et al,1 which reported that the 30-day readmission rates were significantly higher in subjects with elevation in brain-type natriuretic peptide (BNP) level greater than 700 pg/mL (to convert to nanograms per liter, multiply by 1) at the time of discharge who received aggressive fluid and sodium restriction during hospitalization for acute decompensated heart failure. The authors were able to add more data to the continuing narrative on the controversy surrounding salt restriction on health.2 Furthermore, we were interested in the study in that it examined the impact of a nonpharmacological intervention during an acute hospitalization on 30-day readmission rates, as most literature and studies focus on the processes surrounding failures in communication, in planning, and in scheduling follow-up or on performance measure outcomes.3,4

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January 1, 2014
Graziella Aliti, RN, ScD; Eneida Rejane Rabelo, RN, ScD; Luís Beck-da-Silva, MD, ScD
1Heart Failure and Cardiac Transplant Unit, Cardiology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil2School of Nursing, Federal University of Rio Grande do Sul, Porto Alegre, Brazil3Postgraduate Program in Cardiology and Cardiovascular Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
1Heart Failure and Cardiac Transplant Unit, Cardiology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil3Postgraduate Program in Cardiology and Cardiovascular Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
JAMA Intern Med. 2014;174(1):163-164. doi:10.1001/jamainternmed.2013.11088.
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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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