Heart failure & cardiomyopathiesSecondary analysis
The impact of volume and sodium chloride supplementation on diuretic response during decongestion of decompensated heart failure patients
- Post-hoc analysis of two prospective mechanistic studies
- single-centre
Authors' conclusion
Intravenous fluid replacement during decongestion in patients with AHF was associated with increased net natriuresis and a trend towards higher urine output, with a significant augmentation of diuresis with sodium chloride supplementation.
Study context
- Population
- Patients with acute HF and fluid overload receiving standardized furosemide dosing
- Participants
- 55 patients
- Comparison
- IV fluid vs no fluids during decongestion
- NaCln = 21
- Glucosen = 19
- No fluidsn = 15reference
- Primary endpoint
- Urine volume and natriuresis
- Follow-up
- 6 h after loop diuretic administration
Primary result
As reported in the abstract
Cumulative net natriuresis, fluid (n = 40) vs no fluid (n = 15) · 6 h
P = 0.043
Further findings
| Outcome | NaCl | Glucose | No fluids | P value |
|---|---|---|---|---|
| Cumulative net diuresis, fluid vs no fluid · 6 h | Not reported in the abstract | Not reported in the abstract | 1010 (IQR 475–1270) mL | P = 0.078 |
| Diuretic response by fluid type (absolute and net diuresis; natriuresis) | ||||
| Absolute diuresis | 1980 [1620-3150] mL | 1510 [1075-2175] mL | 1010 [475-1270] mL | |
| Net diuresis | 1480 [1120-2650] mL | 1010 [575-1675] mL | 1010 [475-1270] mL |
- Diuretic response by fluid type (absolute and net diuresis; natriuresis) — Absolute diuresis, 3-group comparison
- P < .001
- Diuretic response by fluid type (absolute and net diuresis; natriuresis) — Net diuresis, 3-group comparison
- P = .019
- Diuretic response by fluid type (absolute and net diuresis; natriuresis) — Natriuresis difference not significant
- P = .126
- Cumulative net diuresis, fluid vs no fluid: Fluid therapy 1170 (IQR 880–1890) mL
Original publication
The impact of volume and sodium chloride supplementation on diuretic response during decongestion of decompensated heart failure patients. Eur J Heart Fail. Published 12 January 2026. doi:10.1093/ejhf/xuaf023
Summarised from the published abstract; every number is checked against it