Using urine sodium to guide IV diuretic dosing for hospitalized acute heart failure

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

Adults admitted with acute decompensated heart failure are randomized to one of three arms: a low urine sodium target (50 µmol), a higher urine sodium target (85 µmol), or standard of care. Urine sodium is measured 2–4 hours after intravenous furosemide and, if the natriuretic response is inadequate, the diuretic dose is increased; this approach is repeated during the first 72 hours of admission. Primary comparisons focus on natriuresis and diuresis, with secondary outcomes including hospital length of stay and readmission frequency. The trial is single-center and interventional, using a protocolized urine-sodium-guided escalation of loop diuretics versus usual care.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* The study will target adults 18 years of age or older admitted to Lakeland Regional Medical Center who:

  * Have a primary diagnosis of acute decompensated heart failure, and
  * Have at least one of the following signs of hypervolemia:

    * Bilateral lower extremity pitting edema
    * Jugular venous distension
    * Hepatojugular reflex
    * Crackles on pulmonary exam, or
    * Chest x-ray demonstrating pulmonary edema or pleural effusions

Exclusion Criteria:

* Exclusion criteria include:

  * Admission to the intensive care unit
  * Presence of ST-elevated myocardial infarction
  * Presence of type 1 non-ST elevated myocardial infarction
  * Dyspnea primarily due to non-cardiac cause as judged by the emergency medicine physician or admitting physician
  * Use of supplemental oxygen totaling at least 3 L per minute or greater at baseline
  * Anuria
  * End-stage renal disease per KDIGO criteria
  * Dialysis use

Where it's running

• Lakeland Regional Hospital
  Lakeland, Florida, United States Recruiting

Study contacts

• Principal investigator: Anas Bizanti, MD — Lakeland Regional Hospital
• Study coordinator: Andrew Lurie, DO
• Email: Andrew.Lurie@myLRH.org
• Phone: 8636871100

Similar studies

Other studies for the same condition or treatment. Recruiting studies are listed first.

• Using Apple Watch data to predict heart failure outcomes

  This study is testing if data from Apple Watches can help predict heart failure problems and the chances of needing to go back to the hospital for patients with heart failure.

  Recruiting University Medical Center Goettingen · Goettigen, Lower Saxony · NCT06819618

• Urinary Sodium and Chloride Changes and Fluid Overload in Acute Heart Failure

  This study tests whether tracking urinary sodium and chloride during hospitalization can reflect congestion removal and predict short-term outcomes in adults with acute heart failure treated with IV diuretics.

  Recruiting Fundacion para la Investigacion Biomedica del Hospital Universitario Ramon y Cajal · Olot, Girona and 3 other locations · NCT07597512

• Sarcopenia in older adults with acute heart failure: using muscle ultrasound and biomarkers to predict outcomes

  This study tests whether measuring muscle mass with ultrasound, along with muscle strength and biomarkers, can help predict outcomes for adults 80 and older hospitalized for acute heart failure with preserved ejection fraction.

  Recruiting Fundacion para la Investigacion Biomedica del Hospital Universitario Ramon y Cajal · Madrid, Madrid · NCT07530029

• Prolonged nasogastric ketone infusion for decompensated heart failure

  This will test whether a continuous nasogastric infusion of a ketone (D‑beta‑hydroxybutyrate) can safely reach target blood levels in adults with severely reduced ejection fraction admitted for acute decompensated heart failure or cardiogenic shock.

  Recruiting Phase 4 Institute for Clinical and Experimental Medicine · Prague, Prague · NCT07527156

• Understanding Exacerbations in Heart Failure: Monitoring with Apple Watch

  This study tests whether data from an Apple Watch, combined with clinical information, can help predict worsening heart failure in adults living with the condition.

  Recruiting University Health Network, Toronto · Newmarket, Ontario and 2 other locations · NCT07447908

• Can liver stiffness testing help detect high central venous pressure in heart failure patients

  A non-invasive FibroScan test is being used to see if liver stiffness can indicate elevated central venous pressure in adults with heart failure.

  Recruiting at 6 sites Echosens · Los Angeles, California and 6 other locations · NCT07222813

How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.