Trial reportJournal of cardiac failure2018
Determinants of Diuretic Responsiveness and Associated Outcomes During Acute Heart Failure Hospitalization: An Analysis From the NHLBI Heart Failure Network Clinical Trials.
Trial report in Journal of cardiac failure, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 43 citations in OpenAlex.
- Diuretic Strategies for Loop Diuretic Resistance in Acute Heart Failure: The 3T Trial.JACC. Heart failure · 2020Trial
- A machine-learning model for accurate diuresis prediction in acute heart failure (DRC-AHF).ESC heart failure · 2026Article
- Urine sodium concentration and diuretic responsiveness in dogs receiving orally administered loop diuretics for chronic congestive heart failure.Journal of veterinary internal medicine · 2026Article
- Loop Diuretic Dose Intensification versus Adjuvant Thiazide for Diuretic Resistance in Acute Heart Failure: Mechanistic Randomized Controlled Trial.Journal of the American Society of Nephrology : JASN · 2026Article
- Proteins associated with rehospitalization, mortality and diuretic resistance in acutely decompensated heart failure.ESC heart failure · 2025Article
- Proximal versus distal diuretics in congestive heart failure.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2024Review
- Article
- Epidemiology and Management of Patients With Kidney Disease and Heart Failure With Preserved Ejection Fraction.Seminars in nephrology · 2024Review
- Current Approaches to Worsening Heart Failure: Pathophysiological and Molecular Insights.International journal of molecular sciences · 2024Review
- Extracorporeal veno-venous ultrafiltration in congestive heart failure: What's the state of the art? A mini-review.World journal of cardiology · 2023Review
- Management of Hyponatremia in Heart Failure: Practical Considerations.Journal of personalized medicine · 2023Review
- Diuretic resistance and the role of albumin in congestive heart failure.Drugs in context · 2023Review
- Nalfurafine, a G-Protein-Biased KOR (Kappa Opioid Receptor) Agonist, Enhances the Diuretic Response and Limits Electrolyte Losses to Standard-of-Care Diuretics.Hypertension (Dallas, Tex. : 1979) · 2022Article
- Dose of furosemide before admission predicts diuretic efficiency and long-term prognosis in acute heart failure.ESC heart failure · 2022Observational
- Efficacy of tolvaptan on the short and mid-term prognosis in elderly patients with acute heart failure coexisting with oliguria: A retrospective cohort study.Frontiers in cardiovascular medicine · 2022Article
- Compensatory post-diuretic renal sodium reabsorption is not a dominant mechanism of diuretic resistance in acute heart failure.European heart journal · 2021Article
- Tolvaptan Add-on Therapy to Overcome Loop Diuretic Resistance in Acute Heart Failure With Renal Dysfunction (DR-AHF): Design and Rationale.Frontiers in cardiovascular medicine · 2021Article
- Levosimendan Plus Dobutamine in Acute Decompensated Heart Failure Refractory to Dobutamine.Journal of clinical medicine · 2020Article
- Prediction and measurement of diuretic responsiveness after oral administration of furosemide to healthy dogs and dogs with congestive heart failure.Journal of veterinary internal medicine · 2020Article
- Pathophysiology of Diuretic Resistance and Its Implications for the Management of Chronic Heart Failure.Hypertension (Dallas, Tex. : 1979) · 2020Review
Corrections and comments
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Authors and funding
14 authors at 9 institutions in 1 country.
Funding
Abstract
backgroundPoor response to loop diuretic therapy is a marker of risk during heart failure hospitalization. We sought to describe baseline determinants of diuretic response and to further explore the relationship between this response and clinical outcomes. METHODS AND
resultsPatient data from the National Heart, Lung, and Blood Institute Heart Failure Network ROSE-AHF and CARRESS-HF clinical trials were analyzed to determine baseline determinants of diuretic response. Diuretic efficiency (DE) was defined as total 72-hour fluid output per total equivalent loop diuretic dose. Data from DOSE-AHF was then used to determine if these predictors of DE correlated with response to a high- versus low-dose diuretic strategy. At 72 hours, the high-DE group had median fluid output of 9071 ml (interquartile range: 7240-11775) with median furosemide dose of 320 mg (220-480) compared with 8030 ml (6300-9915) and 840 mg (600-1215) respectively for the low DE group. Cystatin C was independently associated with DE (odds ratio 0.36 per 1mg/L increase; 95% confidence interval: 0.24-0.56; P < 0.001). Independently from baseline characteristics, reduced fluid output, weight loss and DE were each associated with increased 60 day mortality. Among patients with estimated glomerular filtration rate below the median, those randomized to a high-dose strategy had improved symptoms compared with those randomized to a low-dose strategy.
conclusionsElevated baseline cystatin C, as a biomarker of renal dysfunction, is associated with reduced diuretic response during heart failure hospitalization. Higher loop diuretic doses are required for therapeutic decongestion in patients with renal insufficiency. Poor response identifies a high-risk population.
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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.