Heart failure & cardiomyopathies
Combining Loop and Thiazide Diuretics for Acute Heart Failure Across the Estimated Glomerular Filtration Rate Spectrum: A Post-Hoc Analysis of the CLOROTIC Trial
Authors' conclusion
The addition of eGFR-adjusted doses of oral HCTZ to loop diuretics in patients with AHF improved diuretic response across the eGFR spectrum.
Study context
- Population
- Patients with acute heart failure (AHF); median estimated glomerular filtration rate (eGFR) 43 ml/min/1.73 m² (range 14–109)
- Participants
- 230 patients
- Comparison
- Hydrochlorothiazide (HCTZ) added to furosemide vs furosemide alone, by eGFR group
Methodological detailspost-hoc analysis
- Post-hoc analysis
Primary result
As reported in the abstract
Weight difference, HCTZ, eGFR ≥60 ml/min/1.73 m² (group 1)
−2.1 kg
−3.0 to 0.5
Weight difference, HCTZ, eGFR 45–59 ml/min/1.73 m² (group 2)
−1.3 kg
−2.3 to 0.2
Weight difference, HCTZ, eGFR <45 ml/min/1.73 m² (group 3)
−0.1 kg
−1.3 to 0.4
Secondary outcomes
Weight difference with HCTZ by eGFR group · 96 h
kg
- Weight difference, HCTZ, group 1 (eGFR ≥60)
- −1.8 (−3.0 to −0.3)
- Weight difference, HCTZ, group 2 (eGFR 45–59)
- −1.4 (−2.6 to 0.3)
- Weight difference, HCTZ, group 3 (eGFR <45)
- −0.5 (−1.3 to −0.1)
- P-value for interaction = 0.256
Diuretic response, mortality, rehospitalizations, by eGFR group
- No significant differences with HCTZ among the three eGFR groups (all interaction P not significant)
Safety
Impaired renal function, hyponatraemia, hypokalaemia
- No significant differences with HCTZ among the three eGFR groups (all interaction P not significant)
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Summarised from the published abstract; every number is checked against it