Heart failure & cardiomyopathies
Early Diuretic Response and Outcome Prediction in Ambulatory Worsening Heart Failure: Natriuresis Versus Diuresis
Authors' conclusion
In patients with ambulatory WHF treated with IV furosemide, 3-h urinary sodium predicted 30-day outcomes whereas 3-h diuresis did not.
Study context
- Population
- Patients with ambulatory worsening heart failure (WHF) randomized to receive intravenous furosemide with or without hypertonic saline solution
- Participants
- 167 patients
- Comparison
- 3-h urinary sodium (uNa+) vs 3-h urine output (diuresis) following intravenous (IV) diuretic infusion as predictors of 30-day adverse events
Primary result
As reported in the abstract
Composite endpoint:
- Death
- Heart failure hospitalization
- The need for outpatient IV diuretics
Experienced the composite endpoint
50
29.9%
Further findings
AUC-ROC
| Outcome | Inverse of 3-h natriuresis | 3-h diuresis | P value |
|---|---|---|---|
| AUC-ROC for 30-day adverse events | 0.680 | 0.601 | P = 0.092 |
- AUC-ROC for 30-day adverse events: trend towards a higher AUC-ROC for the inverse of 3-h natriuresis
Association of lower 3-h uNa+ with 30-day adverse events
- Lower 3-h uNa+ associated with a higher risk of 30-day adverse events
- P = 0.008
- Multivariate analyses
Association of 3-h diuresis with 30-day adverse outcomes
- 3-h diuresis did not significantly predict 30-day adverse outcomes
- P = 0.424
- Multivariate analyses
Baseline characteristics
- Median age
- 81 years
- Male
- 69.5%
- Patients with lower 3-h urinary sodium and diuresis were older and exhibited reduced kidney function and haemoglobin levels
Original publication
Early Diuretic Response and Outcome Prediction in Ambulatory Worsening Heart Failure: Natriuresis Versus Diuresis. ESC Heart Fail. Published 28 March 2025. doi:10.
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