Heart failure & cardiomyopathies

Fluid restriction vs liberal intake in patients with heart failure: a meta-analysis of randomized trials

ESC Heart FailPublished meta-analysis of randomized trials

Pooled result · All-cause mortalityResult — go to the resultRelative risk 0.54 95% CI 0.31–0.94

Authors' conclusion

Fluid restriction reduces the risk of all-cause mortality but not HF rehospitalizations in HF patients. Further studies are warranted to definitively confirm the present findings and result on the suitable changes in recommendations and clinical practice.

Study context

Population
HF patients9 randomized controlled trials (RCTs), mean follow-up: 196.33 days · fluid restriction (FR) group 614 · non-FR group 657
Participants
1,271 patients
Comparison
FR vs liberal fluid intake
  • FRn = 614
  • non-FRn = 657reference
Methodological detailssystematic literature search, random-effects model with the Hartung-Knapp-Sidik-Jonkman (HKSJ) adjustment
  • Systematic literature search
  • Random-effects model with the Hartung-Knapp-Sidik-Jonkman (HKSJ) adjustment

Pooled result

All-cause mortality

Relative risk

0.54

95% CI 0.31–0.94

P = 0.03

FR vs non-FR
RR 0.54 (95% CI 0.31–0.94); P = 0.03

As reported in the abstract

Further pooled results

OutcomeRR (95% CI)P value
Heart failure hospital readmissions0.67 (0.28–1.65)P = 0.31
OutcomeWMD (95% CI)P value
Perceived thirst−6.89 (−22.86 to 9.08)P = 0.26
OutcomeWMD (pg/mL) (95% CI)P value
Serum BNP levels54.09 (−316.86 to 425.04)P = 0.71
OutcomeWMD (mmol/L) (95% CI)P value
Sodium levels1.42 (−0.68 to 3.51)P = 0.15

Mean age

Original publication

Fluid restriction vs liberal intake in patients with heart failure: a meta-analysis of randomized trials. ESC Heart Fail. Published 8 January 2026. doi:10.1093/eschf/xvaf004

Summarised from the published abstract; every number is checked against it

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