Fluid, Sodium Restriction Does Not Improve Clinical Stability of Acute Decompensated Heart Failure Patients


Aggressive fluid and sodium restriction among patients hospitalized with acute decompensated heart failure (ADHF) has no effect on weight loss, clinical stability or 30-day readmission rates, according to new randomized clinical trial results published in JAMA Internal Medicine.

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The study, led by Graziella Badin Alitti, RN, ScD, Federal University of Rio Grande do Sul, Porto Alegre, Brazil, randomized 38 patients with ADHF to a maximum fluid intake of 800 mL/d and maximum dietary sodium intake of 800 mg/d. These patients were compared with 37 patients who received a normal hospital diet with unrestricted fluid and sodium intake. Patients were evaluated for weight loss, clinical stability and daily perception of thirst after three days of hospitalization, as well as 30-day readmissions.

No statistically significant differences in weight loss, clinical stability and hospital readmissions were observed between patients with a restricted diet and regular diet. However, patients randomized to the low-fluid and low-sodium diet reported significantly worse thirst (p=0.01). The investigators concluded that the restrictive diet provided no benefit.

"Aggressive fluid and sodium restriction has no effect on weight loss or clinical stability at three days and is associated with a significant increase in perceived thirst," wrote the investigators. "We conclude that sodium and water restriction in patients admitted for ADHF are unnecessary."

Clinical Topics: Diabetes and Cardiometabolic Disease, Heart Failure and Cardiomyopathies, Prevention, Acute Heart Failure, Diet

Keywords: Thirst, Diet, Sodium-Restricted, Sodium, Dietary, Sodium, Patient Readmission, Weight Loss, Heart Failure, Hospitalization

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