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Sodium, fluid restriction unnecessary for acute decompensated HF
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For patients with acute decompensated heart failure, clinicians often use sodium and fluid restrictions as treatment regimen. However, recent data suggest this nonpharmacologic method has no benefit on weight loss or clinical stability after 3 days. Rather, it increased perceived thirst.
To compare the effects of a fluid-restricted (maximum fluid intake: 800 mL per day) and sodium-restricted (maximum dietary intake: 800 mg per day) diet, researchers from Brazil conducted a parallel-group clinical trial consisting of 75 patients who were randomly assigned to a diet (n=38) or control group (n=37). In the control group, researchers administered a standard hospital diet and liberal fluid and sodium intake.
According to data, ischemic heart disease was the leading cause of heart failure (n=17; 23%), followed by the mean left ventricular ejection fraction (26%). The researchers also found that patients from both groups demonstrated similar weight loss (between-group difference in variation: 0.25 kg; 95% CI, –1.95 to 2.45) in addition to similar clinical congestion scores at 3 days (between-group difference in variation: 0.59 points; 95% CI, –2.21 to 1.03).
However, data indicate that thirst was significantly poor in the intervention group (5.1) compared with the control group (3.44) at the completion of the study (between-group difference = 1.66 points; time × group interaction; P=.01).
Moreover, researchers found no significant between-group differences regarding the readmission rate at 30 days (intervention, 29%; control, 19%), they wrote.
“Therefore, the current evidence suggests that increasing rather than restricting sodium intake may be beneficial in patients with acute decompensated heart failure (ADHF),” the researchers wrote. “In summary, the effect of fluid restriction appears neutral.”
Disclosure: The researchers report no relevant financial disclosures.
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