Comparing Diuretic Strategies in Hospitalized Heart Failure

Creating a Platform for Point-of-Care Pragmatic Clinical Trials: Comparing Diuretic Strategies in Heart Failure

We will conduct a pragmatic randomized trial comparing whether using a combination of two types of diuretics (loop + thiazide) compared with using a single diuretic (loop only) will result in shorter hospital stays for patients hospitalized with heart failure.

Inclusion Criteria:

Any adult (age ≥18 years) admitted to the Heart Failure Service at Stanford Health Care with an indication for treatment with a diuretic.

Exclusion Criteria:

1. admission to the intensive care unit or cardiac care units
2. maintenance dialysis on admission
3. any mechanical circulatory support on admission
4. history of heart transplant
5. allergy / intolerance to loop or thiazide diuretics
6. admission serum sodium < 125 meq/L (from EPIC)
7. admission serum potassium < 3.0 meq/L (from EPIC)