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

Yoshitaka Okuhara, Shinichi Hirotani, Yoshiro Naito, Ayumi Nakabo, Toshihiro Iwasaku, Akiyo Eguchi, Daisuke Morisawa, Tomotaka Ando, Hisashi Sawada, Eri Manabe, Tohru Masuyama

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

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.

Original languageEnglish
Pages (from-to)295-301
Number of pages7
JournalJournal of Cardiac Failure
Volume20
Issue number5
DOIs
StatePublished - May 2014

Keywords

  • glomerular filtration rate
  • heart failure
  • loop diuretics
  • Salt restriction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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