Study of Adjusting Diuretic Dose by Urine Sodium Levels to Improve Treatment in Adults Hospitalized with Acute Heart Failure

What this Trial Is About

Researchers are evaluating whether increasing the dose of diuretics to reach a higher urine sodium target improves treatment outcomes in adults hospitalized with acute decompensated heart failure compared to standard care. The study aims to find out if targeting higher urine sodium levels leads to better natriuresis and diuresis, reduces hospital readmissions, and shortens hospital stays. Participants will be randomly assigned to one of three groups standard care, diuretics adjusted to achieve a urine sodium concentration of 50 mmolL, or diuretics adjusted to reach 85 mmolL. Urine sodium levels will be checked two to four hours after intravenous diuretic administration, and if levels are low, the diuretic dose will be increased. This adjustment process will continue during the first 72 hours of hospital admission. During the trial, participants will provide urine samples at routine intervals to monitor sodium levels and treatment response. Researchers will assess natriuresis and diuresis at 24 and 48 hours, length of hospital stay, readmission rates at 30 and 90 days, weight changes, and net fluid balance. The study will last through hospitalization and follow participants up to 90 days post-discharge to evaluate clinical outcomes and safety.

Urine Sodium-Driven Diuretic Adjustment Strategy in Acute Decompensated Heart Failure