• Yoshitaka Okuhara, Shinichi Hirotani, Yoshiro Naito, Ayumi Nakabo, Toshihiro Iwasaku, Akiyo Eguchi, Daisuke Morisawa, Tomotaka Ando, Hisashi Sawada, Eri Manabe, and Tohru Masuyama.
• Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan.
• J. Card. Fail. 2014 May 1; 20 (5): 295-301.

BackgroundTheoretically, 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 ResultsThis 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).ConclusionsSalt supplementation rather than salt restriction evoked favorable diuresis through increasing GFR. The findings support an efficacious novel approach of the treatment of ADHF.Copyright © 2014 Elsevier Inc. All rights reserved.

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