Home › Heart Failure › NCT07263035

Urine Sodium-Driven Diuretic Adjustment Strategy in Acute Decompensated Heart Failure

Who can join

Ages 18 and older · All sexes

Inclusion Criteria:

* The study will target adults 18 years of age or older admitted to Lakeland Regional Medical Center who:

  * Have a primary diagnosis of acute decompensated heart failure, and
  * Have at least one of the following signs of hypervolemia:

    * Bilateral lower extremity pitting edema
    * Jugular venous distension
    * Hepatojugular reflex
    * Crackles on pulmonary exam, or
    * Chest x-ray demonstrating pulmonary edema or pleural effusions

Exclusion Criteria:

* Exclusion criteria include:

  * Admission to the intensive care unit
  * Presence of ST-elevated myocardial infarction
  * Presence of type 1 non-ST elevated myocardial infarction
  * Dyspnea primarily due to non-cardiac cause as judged by the emergency medicine physician or admitting physician
  * Use of supplemental oxygen totaling at least 3 L per minute or greater at baseline
  * Anuria
  * End-stage renal disease per KDIGO criteria
  * Dialysis use

About the study

The goal of this clinical trial is to learn if increasing the dose of diuretics to achieve a higher urine sodium target produces better clinical results when treating patients hospitalized with acute heart failure when compared to lower urine sodium target and standard of care.

The main questions it aims to answer are:

1. Does targeting a higher urine sodium goal achieve greater natriuresis and diuresis? 2. Does targeting a higher urine sodium goal reduce frequency of hospital readmissions? 3. Does targeting a higher urine sodium goal reduce hospital length of stay?

Researchers will compare natriuresis-guided arms with standard of care to see if targeting higher natriuresis goals improves significantly over current practice.

Participants will submit urine samples at routine intervals after being given diuretics to evaluate urine sodium concentration. If urine sodium is low then diuretic dose will be increased.

What is being tested

• Furosemide intravenous solution (drug)
• Furosemide intravenous solution (drug)
• Furosemide intravenous solution (drug)

Sponsor: Lakeland Regional Health Systems, Inc. · Participants: 600 · Started: Apr 1, 2026

Contact the study team

• Andrew Lurie, DO · Phone: 8636871100
• Anas Bizanti, MD · Phone: 8636871100

Official record on ClinicalTrials.gov — NCT07263035

Locations in the U.S.

Conditions

• Heart Failure

From ClinicalTrials.gov, data retrieved Sep 30, 2026. Each study sets its own eligibility; the study team decides who can join.