Trial reportEuropean journal of heart failure2025
Outpatient loop diuretic use and the effect of natriuresis-guided diuretic therapy: A prespecified sub-analysis of the PUSH-AHF study.
Trial report in European journal of heart failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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
1 citing paper in PubMed.
- Beyond Blood Pressure: Salt Sensitivity as a Cardiorenal Phenotype-A Narrative Review.Life (Basel, Switzerland) · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
Abstract
aimsDiuretic resistance is frequently observed in patients with acute decompensated heart failure (ADHF), specifically in those with chronic use of loop diuretics (LD). Natriuresis-guided therapy may be useful to overcome this, however it is unknown whether its effect is impacted by chronic LD use. The aim of this study was to evaluate the effect of outpatient LD use on natriuresis and clinical outcomes, and to determine whether natriuresis-guided therapy modifies these effects in patients hospitalized for ADHF. METHODS AND
resultsIn this prespecified sub-analysis of the PUSH-AHF trial, the association between outpatient LD use, predefined primary, secondary and safety outcomes as established in the PUSH-AHF protocol, and the effect of natriuresis-guided therapy as compared with standard of care was evaluated. Patients in both arms received the first in-hospital LD dose based on renal function and outpatient LD dose. Out of 310 randomized patients, 133 (43%) had no prior LD use, 65 (21%) used 0-1 mg bumetanide and 112 (36%) used >1 mg bumetanide (or equivalent). Patients with higher outpatient LD doses had a longer history of heart failure and worse renal function (p for trend <0.001). Higher outpatient LD doses were associated with lower 24-h natriuresis (340 ± 194 mmol vs. 420 ± 200 mmol in diuretic-naïve patients, p for trend = 0.002). Natriuresis-guided therapy significantly increased 24-h natriuresis regardless of outpatient LD use (p for interaction = 0.420). No interaction between outpatient LD use, natriuresis-guided therapy and the effect on the combined endpoint of heart failure rehospitalization or all-cause mortality at 180 days was observed (p for interaction = 0.881).
conclusionsOutpatient LD use results in reduced natriuresis. However, the beneficial effects of natriuresis-guided diuretic therapy on 24-h natriuresis were consistent, regardless of previous LD use.
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