Spot Urinary Analysis to Assess Loop Diuretic Efficiency in Stable Heart Failure

Diuretic Efficiency in Patients With Stable Heart Failure: Ion Excretion Capacity of the Kidneys (DIPSTICK) Study

The primary objective of this study is to assess whether the urinary sodium/creatinine or chloride/creatinine ratio might predict successful downtitration of loop diuretics in patients with stable heart failure without clinical signs of volume overload. In addition, this study will provide information on loop diuretic efficiency and urinary electrolyte composition after intake of diuretics in stable outpatients with heart failure.

Inclusion Criteria:

• Patient has a left ventricular ejection fraction <40% or has been previously hospitalized with a primary diagnosis of heart failure
• Patient receives a daily maintenance dose of loop diuretics

Exclusion Criteria:

• Patient was hospitalized for heart failure <3 months before study inclusion
• The maintenance dose of loop diuretics was changed <3 months before study inclusion
• The maintenance dose of renin-angiotensin-aldosterone system blockers or beta-blocker medication was changed <3 months before study inclusion
• Cardiac resynchronization therapy (CRT) was initiated <3 months before study inclusion
• At the moment of inclusion, the patient has either one of the following signs of volume overload: lower leg edema +2/4, ascites, lung congestion
• Patient is not able to measure his/her weight safely and correct at home