No Need for Fluid or Sodium Restriction in Patients with ADHF

In a small randomized trial, the only significant effect of a low-fluid, low-salt diet in hospitalized patients was increased thirst.

Admission orders for patients with acute decompensated heart failure (ADHF) habitually include both sodium and free water restriction. However, data to support these restrictions are extremely limited and — at best — inconclusive. To assess this practice more rigorously, investigators randomized 75 adults hospitalized with acute systolic HF (mean age, 60; 69% men; ischemic HF etiology, 23%; mean left ventricular ejection fraction, 26%) at a single center to either fluid and sodium restriction (≤800 mL/day and ≤800 mg/day, respectively) or a standard diet (fluid, ≥2.5 L/day; sodium, 3–5 g/day) for up to 7 days or until hospital discharge.

The primary endpoint — weight loss and change in clinical congestion score (CCS) at 3 days — did not diff…

Reviewing Author

Frederick A. Masoudi, MD, MSPH, FACC, FAHA

Disclosures

Consultant/Advisory BoardBristol Myers Squibb; CPC Clinical Research

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsUpToDate; American College of Cardiology Self-Assessment Program (SAP)

Leadership Positions in Professional SocietiesAmerican College of Cardiology (Chair, Innovations Committee)