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Intravenous salt supplementation with low-dose furosemide for treatment of acute decompensated heart failure.

Abstract：

BACKGROUND:Theoretically, salt supplementation should promote diuresis through increasing the glomerular filtration rate (GFR) during treatment of acute decompensated heart failure (ADHF) even with low-dose furosemide; however, there is little evidence to support this idea. METHODS AND RESULTS:This was a prospective, randomized, open-label, controlled trial that compared the diuretic effectiveness of salt infusion with that of glucose infusion supplemented with low-dose furosemide in 44 consecutive patients with ADHF. Patients were randomly administered 1.7% hypertonic saline solution supplemented with 40 mg furosemide (salt infusion group) or glucose supplemented with 40 mg furosemide (glucose infusion group). Our major end points were 24-hour urinary volume and GFR. Urinary volume was greater in the salt infusion group than in the glucose infusion group (2,701 ± 920 vs 1,777 ± 797 mL; P < .001). There was no significant difference in the estimated GFR at baseline. Creatinine clearance for 24 h was greater in the salt infusion group than in the glucose infusion group (63.5 ± 52.6 vs 39.0 ± 26.3 mL min(-1) 1.73 m(-2); P = .048). CONCLUSIONS:Salt supplementation rather than salt restriction evoked favorable diuresis through increasing GFR. The findings support an efficacious novel approach of the treatment of ADHF.

journal_name

J Card Fail

journal_title

Journal of cardiac failure

authors

Okuhara Y,Hirotani S,Naito Y,Nakabo A,Iwasaku T,Eguchi A,Morisawa D,Ando T,Sawada H,Manabe E,Masuyama T

doi

10.1016/j.cardfail.2014.01.012

subject

Has Abstract

pub_date

2014-05-01 00:00:00

pages

295-301

issue

5

eissn

1071-9164

issn

1532-8414

pii

S1071-9164(14)00015-3

journal_volume

20

pub_type

杂志文章,随机对照试验

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