Evidence map›Paper›PMID 25560378›Full record

ReviewNature reviews. Cardiology2015

Diuretic response in acute heart failure-pathophysiology, evaluation, and therapy.

Jozine M ter Maaten, Mattia A E Valente, Kevin Damman, Hans L Hillege, Gerjan Navis, Adriaan A Voors

Registry-linked trialAbstract readReview
PubMed Publisher
In one paragraph

Review in Nature reviews. Cardiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01647932 (Safety and Efficacy of the Combination of Loop Diuretics With Thiazide-type Diuretics in Patients With Decompensated Heart Failure), which is not on this map. Cited by 116 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
116citing papers in PubMed, 3 pooled it
15.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01647932 phase3completednot on this map

Safety and Efficacy of the Combination of Loop Diuretics With Thiazide-type Diuretics in Patients With Decompensated Heart Failure: a Double-blind, Randomized, Placebo-controlled Trial (CLOROTIC Trial).

TypeinterventionalSponsorSpanish Society of Internal MedicineRan2014 to 2019Enrolled232ConditionsHeart FailureArmshydrochlorothiazide, Placebo
3 · Its place in the literature

Who cites it

116 citing papers in PubMed, 3 syntheses or guidelines pooled it, 258 citations in OpenAlex.

  1. Acetazolamide as an Adjunctive Diuretic Therapy for Patients with Acute Decompensated Heart Failure: A Systematic Review and Meta-Analysis.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2024 · on this map
    Pooled it
  2. Ultrafiltration for acute heart failure.The Cochrane database of systematic reviews · 2022
    Pooled it
  3. Pooled it
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  14. Early treatment with tolvaptan improves diuretic response in acute heart failure with renal dysfunction.Clinical research in cardiology : official journal of the German Cardiac Society · 2017
    Trial
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  16. An integrated overview of acute heart failure: a narrative review of pathophysiological mechanisms and contributing factors.The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2026
    Review
  17. Review
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  19. Article
  20. Urinary sodium and right ventricular function in acute heart failure.Clinical research in cardiology : official journal of the German Cardiac Society · 2026
    Article

56 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Jozine M ter MaatenDepartment of Cardiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, Netherlands.
Mattia A E ValenteDepartment of Cardiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, Netherlands.
Kevin DammanDepartment of Cardiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, Netherlands.
Hans L HillegeDepartment of Cardiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, Netherlands.
Gerjan NavisDepartment of Nephrology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, Netherlands.
Adriaan A VoorsDepartment of Cardiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, Netherlands.
University Medical Center Groningen · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The administration of loop diuretics to achieve decongestion is the cornerstone of therapy for acute heart failure. Unfortunately, impaired response to diuretics is common in these patients and associated with adverse outcomes. Diuretic resistance is thought to result from a complex interplay between cardiac and renal dysfunction, and specific renal adaptation and escape mechanisms, such as neurohormonal activation and the braking phenomenon. However, our understanding of diuretic response in patients with acute heart failure is still limited and a uniform definition is lacking. Three objective methods to evaluate diuretic response have been introduced, which all suggest that diuretic response should be determined based on the effect of diuretic dose administered. Several strategies have been proposed to overcome diuretic resistance, including combination therapy and ultrafiltration, but prospective studies in patients who are truly unresponsive to diuretics are lacking. An enhanced understanding of diuretic response should ultimately lead to an improved, individualized approach to treating patients with acute heart failure.

Indexed as

Acute DiseaseDrug ResistanceDrug Therapy, CombinationHeart FailureHumansSodium Potassium Chloride Symporter InhibitorsTreatment OutcomeSodium Potassium Chloride Symporter Inhibitors

Identifiers

PMID25560378
OpenAlexW2082244841

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.