Urine sodium spot testing to guide diuretic dosing in people with chronic heart failure
Official title: Spot Analysis of Natriuresis to Guide up- or Down-titration of Diuretic Therapy in Ambulatory Patients With Chronic Heart Failure (SAND-HF)
Run by Cardiology Research UBC · NCT07369856 · Data updated 2026-11-12
This pilot will test whether a quick urine sodium test can help guide increasing or decreasing loop diuretics for people living with chronic heart failure.
Quick facts
| Study type | Interventional |
|---|---|
| Ages | 18 Years and up |
| Sex | All |
| Enrollment | 300 (estimated) |
| Sponsor | Cardiology Research UBC Academic / other |
| Locations | 1 site (Vancouver, British Columbia) |
| Status | Recruiting |
| Started | November 4, 2025 |
| Main results expected | May 31, 2027 |
| Study ends | December 30, 2027 |
| Registry record updated | March 27, 2026 |
| Trial ID | NCT07369856 on ClinicalTrials.gov |
Is this trial a fit for you?
✓Likely a good fit
Adults with chronic heart failure who use loop diuretics and either have signs of congestion (for up‑titration) or are clinically stable/euvolemic (for down‑titration), and who live in the study's regional catchment area are ideal candidates.
✕Probably not a fit
Patients with severe kidney failure (eGFR <20 mL/min/1.73 m²), on renal replacement therapy, acutely unstable or requiring hospitalization, or unable to provide urine samples are unlikely to receive benefit from this approach.
A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.
What this trial studies
This prospective pilot enrolls ambulatory heart failure patients on loop diuretics and assigns them to one of three groups based on congestion status. Participants in the up‑titration and down‑titration cohorts are randomized 1:1 to natriuresis‑guided therapy using a point‑of‑care urine sodium sensor or to standard care, while a third group is followed observationally. Diuretic doses in the randomized arms are adjusted according to predefined urine sodium algorithms, with measurements at baseline and follow‑up over a 90‑day period. The primary aim is feasibility (recruitment, retention, sampling adherence, and workflow), with secondary analyses of clinical outcomes and usability.
Why it matters
Potential benefit: If successful, this approach could enable more precise diuretic dosing—improving congestion control, reducing hospital visits, and avoiding unnecessary diuretic use.
How similar studies have gone: Previous work shows spot urine sodium correlates with diuretic response in acute and observational settings, but using a point‑of‑care urine sodium test to guide outpatient up‑ or down‑titration is relatively novel and not yet proven in large trials.
Who can join: the full rules
Show full inclusion / exclusion criteria
Inclusion Criteria: * Age ≥18 years * Diagnosis of heart failure according to the Universal Definition * Use of loop diuretics * Residing in VCH or PHC regions Group-specific inclusion: Group 1: Congestion score ≥5 OR objective congestion; stable furosemide ≥1 week Group 2: NYHA I-II; congestion score \<5; no recent HF hospitalization; stable furosemide ≥1 month Group 3: First 100 eligible patients not meeting criteria for Groups 1 or 2 Exclusion Criteria: * eGFR \<20 mL/min/1.73m² * Renal replacement therapy * High-risk clinical status requiring hospitalization * Inability to consent or perform required urine sampling
Where it's running
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Vancouver General Hospital
Vancouver, British Columbia, Canada Recruiting
Study contacts
- Study coordinator: Natalie Bloch, MD
- Email: natalie.blochisenberg@vch.ca
- Phone: 604-875-4111
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How to take part
- Review the eligibility criteria above with your treating physician.
- Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
- Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.