Heart failure & cardiomyopathies
Sodium Chloride Versus Glucose Solute as a Volume Replacement Therapy for More Effective Decongestion in Acute Heart Failure (SOLVRED-AHF): A Prospective, Randomized, Mechanistic Study
Authors' conclusion
The infusion of NaCl compared to glucose added to diuretic therapy led to significantly higher diuresis, natriuresis, and lower loop diuretic use, driven by lower sodium avidity and inhibition of proximal tubular sodium reabsorption.
Study context
- Population
- Patients with acute heart failure (AHF) and fluid overload
- Participants
- 25 vs 25
- Comparison
- 0.9% NaCl vs 5% glucose infusion added to protocolized diuretic therapy
- NaCln = 25
- Glucosen = 25reference
- Primary endpoint
- Co-primary: 24- and 48-h urine output, natriuresis within 48 h, total furosemide dose up to 48 h
- Follow-up
- Up to 48 h
Methodological detailssingle-centre, prospective, single-blind, mechanistic
- Single-centre
- Prospective
- Single-blind
- Mechanistic
Primary result
As reported in the abstract
Co-primary endpoints
| Group | Cumulative urine output 48 h | Cumulative furosemide dose |
|---|---|---|
| NaCl | 9500 ml | 220 mg |
| Glucose | 7395 ml | 280 mg |
Cumulative urine output 48 h
NaCl9500 ml
Glucose7395 ml
Cumulative furosemide dose
NaCl220 mg
Glucose280 mg
- NaCl vs Glucose: P = 0.001 — cumulative urine output 48 h
- NaCl vs Glucose: P < 0.05 — natriuresis during 48 h (higher with NaCl)
- NaCl vs Glucose: P = 0.02 — cumulative furosemide dose (lower with NaCl)
Further findings
Fractional excretion of lithium · inhibited proximal tubular sodium reabsorption
P = 0.030
Relative distal sodium reabsorption
P < 0.001
Relative distal sodium reabsorption
- No difference in absolute distal reabsorption
Original publication
Sodium Chloride Versus Glucose Solute as a Volume Replacement Therapy for More Effective Decongestion in Acute Heart Failure (SOLVRED-AHF): A Prospective, Randomized, Mechanistic Study. Eur J Heart Fail. Published 2 June 2025. doi:10.
Summarised from the published abstract; every number is checked against it