TY - JOUR
T1 - Intravenous salt supplementation with low-dose furosemide for treatment of acute decompensated heart failure
AU - Okuhara, Yoshitaka
AU - Hirotani, Shinichi
AU - Naito, Yoshiro
AU - Nakabo, Ayumi
AU - Iwasaku, Toshihiro
AU - Eguchi, Akiyo
AU - Morisawa, Daisuke
AU - Ando, Tomotaka
AU - Sawada, Hisashi
AU - Manabe, Eri
AU - Masuyama, Tohru
PY - 2014/5
Y1 - 2014/5
N2 - 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.
AB - 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.
KW - glomerular filtration rate
KW - heart failure
KW - loop diuretics
KW - Salt restriction
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U2 - 10.1016/j.cardfail.2014.01.012
DO - 10.1016/j.cardfail.2014.01.012
M3 - Article
C2 - 24462960
AN - SCOPUS:84899847534
VL - 20
SP - 295
EP - 301
IS - 5
ER -