Heart failure & cardiomyopathiesCohort study
Impact of routine urine sodium evaluation on diuretic practices in patients with acute heart failure
- Multivariable logistic regression; propensity score matching for sensitivity analysis
- prospective post-implementation patients
- historical controls
Authors' conclusion
Routine urine sodium measurement in acute HF patients in intensive care settings was associated with more aggressive diuretic use, increased diuresis, and more rapid improvement in congestion markers.
Study context
- Population
- Patients admitted with acute heart failure (HF) to an intensive cardiac care unitpost-implementation patients 160 · historical controls 206
- Participants
- 160 vs 206
- Exposure
- diuretic prescribing in 160 prospective post-implementation patients (up to April 2023) with 206 historical controls (from January 2020)
- Post-implementationn = 160
- historical controlsn = 206reference
Main finding
As reported in the abstract
Total furosemide dose · 72 h
P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | adjusted OR (95% CI) | P value | |
|---|---|---|---|
| Aggressive diuresis (upper tertile of total furosemide dose within first 72 h, ≥340 mg) | 4.8 (2.86–8.25) | P < 0.001 | |
| Aggressive diuresis, propensity score matched cohort (sensitivity analysis) · Propensity score matching of 264 patients · consistent results | 5.2 (3.004–9.46) | P < 0.001 | |
| 0.10.31310Adjusted odds ratio (log scale) |
Cumulative urine output · 72 h · higher post-implementation
P < 0.001
Resolution of jugular venous distension · 72 h · more frequent post-implementation
P < 0.001
Resolution of peripheral oedema · 72 h · more frequent post-implementation
P = 0.009
Pleural effusion · 72 h · no difference
P = 0.550
Baseline characteristics
- Median age
- 71 (interquartile range 60-80)
- Men
- 252 (69%)
Original publication
Impact of routine urine sodium evaluation on diuretic practices in patients with acute heart failure. ESC Heart Fail. Published 27 April 2026. doi:10.1093/eschf/xvag119
Summarised from the published abstract; every number is checked against it