Heart failure & cardiomyopathiesRandomised controlled trial

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 FailPublished

  • Randomised controlled trial
  • single-centre
  • prospective
  • single-blind
  • mechanistic

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

Primary result

As reported in the abstract

Co-primary endpoints
GroupCumulative urine output 48 hCumulative furosemide dose
NaCl9500 ml220 mg
Glucose7395 ml280 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:10.1002/ejhf.3708

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