Aggressive fluid and sodium restriction in decompensated heart failure with preserved ejection fraction: Results from a randomized clinical trial.
Study Goal
The researchers aimed to compare the effects of sodium and fluid restriction versus an unrestricted diet in patients admitted for decompensated heart failure with preserved ejection fraction (HFpEF).
Results Summary
The study found no significant benefits of aggressive sodium and fluid restriction in terms of weight loss, clinical stability, or prognosis, but it did increase thirst perception and reduce energy intake. No significant differences were observed between groups at 30 days.
Population
Patients admitted for decompensated HFpEF (mean ejection fraction ~60-62%).
Effective Dosage
Sodium (0.8 g/d) and fluid (800 mL/d) restriction.
Duration
7 days or until hospital discharge.
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
diet with sodium (0.8 g/d) and fluid (800 mL/d) restriction | no change | weight loss | patients admitted for decompensated HFpEF | 1.6 ± 2.2 kg in the IG and 1.8 ± 2.1 kg in CG | was similar | #1 |
diet with sodium (0.8 g/d) and fluid (800 mL/d) restriction | no change | reduction in the congestion score | patients admitted for decompensated HFpEF | IG = 3.4 ± 3.5; CG = 3.8 ± 3.4 | was similar | #2 |
diet with sodium (0.8 g/d) and fluid (800 mL/d) restriction | increase | daily perception of thirst | patients admitted for decompensated HFpEF | - | was higher | #3 |
diet with sodium (0.8 g/d) and fluid (800 mL/d) restriction | decrease | energy consumption | patients admitted for decompensated HFpEF | - | Lower | #4 |
diet with sodium (0.8 g/d) and fluid (800 mL/d) restriction | no change | readmission, and mortality rate | patients admitted for decompensated HFpEF | - | No significant between-group differences | #5 |
Aggressive sodium and fluid restriction | no change | symptomatic or prognosis benefits | patients admitted for decompensated HFpEF | - | does not provide | #6 |
Aggressive sodium and fluid restriction | increase | perception of thirst | patients admitted for decompensated HFpEF | - | does produce greater | #7 |
Aggressive sodium and fluid restriction | decrease | patient's food intake | patients admitted for decompensated HFpEF | - | may impair | #8 |
Aggressive sodium and fluid restriction | no change | neurohormonal effect | patients admitted for decompensated HFpEF | - | does not seem to have an important | #9 |
OBJECTIVES: Sodium and fluid restriction is commonly prescribed for heart failure patients. However, its role in the treatment of heart failure with preserved ejection fraction (HFpEF) remains unclear. The aim of this study was to compare the effect of a diet with sodium and fluid restriction with an unrestricted diet in patients admitted for decompensated HFpEF. METHODS: Patients were randomized to a diet with sodium (0.8 g/d) and fluid (800 mL/d) restriction (intervention group [IG]) or an unrestricted diet (control group [CG]) and followed for 7 d or hospital discharge. The primary outcome was weight loss. Secondary outcomes included clinical stability, perception of thirst, neurohormonal activation, nutrient intake, readmission, and mortality rate after 30 d. RESULTS: Fifty-three patients were included (30, IG; 23, CG). The mean ejection fraction was 62% ± 8% for IG and 60% ± 7% for CG (P = 0.44). Weight loss was similar in both groups, being 1.6 ± 2.2 kg in the IG and 1.8 ± 2.1 kg in CG (P = 0.49) as well as the reduction in the congestion score (IG = 3.4 ± 3.5; CG = 3.8 ± 3.4; P = 0.70). The daily perception of thirst was higher in the IG (P = 0.03). Lower energy consumption was seen in the IG (P <0.001). No significant between-group differences at 30 d were found. CONCLUSIONS: Aggressive sodium and fluid restriction does not provide symptomatic or prognosis benefits, but does produce greater perception of thirst, may impair the patient's food intake, and does not seem to have an important neurohormonal effect in patients admitted for decompensated HFpEF.