Heart failure & cardiomyopathies
Renal Function and Natriuresis-Guided Diuretic Therapy – A Pre-Specified Analysis from the PUSH-AHF Trial
Authors' conclusion
Natriuresis-guided diuretic treatment improved diuresis and natriuresis irrespective of baseline eGFR and occurrence of WRF, was effective even in patients with low eGFR, and the observed effect on eGFR was transient and not associated with worse clinical outcomes.
Study context
- Population
- Patients with acute heart failure (HF)
- Participants
- 309 patients
- Comparison
- Natriuresis-guided diuretic therapy vs standard of care, by baseline estimated glomerular filtration rate (eGFR)
- Primary endpoint
- Interaction between randomised treatment, baseline eGFR and the dual primary outcome of PUSH-AHF: total natriuresis at 24 h and time to all-cause mortality or HF rehospitalization at 180 days
Methodological detailspre-specified analysis
- Pre-specified analysis
Primary result
As reported in the abstract
Modification of treatment effect by baseline eGFR
- Baseline eGFR did not significantly modify the treatment effect on natriuresis at 24 h
- p for interaction = 0.730
- Baseline eGFR significantly modified the effect on all-cause mortality and HF rehospitalization at 180 days; risk lower with lower eGFR in natriuresis-guided group
- p for interaction = 0.017
Further findings
- Median baseline eGFR (ml/min/1.73 m²)
- 53 (35-73)
- eGFR <60 ml/min/1.73 m²
- 58%
Safety
ml/min/1.73 m²
| Outcome | Natriuresis-guided | Standard of care | P value |
|---|---|---|---|
| Change in eGFR · first 3 days | −11.0 | −6.91 | P = 0.002 |
| Change in eGFR · discharge | −10.3 | −8.69 | P = 0.38 |
Worsening renal function (WRF) at 72 h
- WRF more frequent with natriuresis-guided treatment, but not associated with worse clinical outcomes
Original publication
Renal Function and Natriuresis-Guided Diuretic Therapy – A Pre-Specified Analysis from the PUSH-AHF Trial. Eur J Heart Fail. Published 12 May 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →