[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-study-detail:100621379":3},{"organization":4,"armGroups":7,"interventions":33,"overallOfficials":39,"centralContacts":50,"locations":57,"responsibleParty":80,"collaborators":39,"id":83,"slug":84,"hasResults":85,"nctId":86,"briefTitle":87,"officialTitle":88,"acronym":89,"eligibilityCriteria":90,"healthyVolunteers":85,"sex":91,"minAge":92,"maxAge":39,"enrollmentInfo":93,"targetDuration":39,"studyType":96,"phases":97,"briefSummary":99,"conditions":100,"keywords":103,"overallStatus":60,"whyStopped":39,"lastUpdateSubmitDate":107,"lastUpdatePostDateStruct":108,"startDateStruct":111,"completionDateStruct":113,"leadSponsor":115,"locationsCount":116},{"fullName":5,"class":6},"Cardiology Research UBC","OTHER",[8,14,19,24,28],{"label":9,"type":10,"description":11,"interventionNames":12},"Group 1 - Natriuresis-Guided Up-Titration","EXPERIMENTAL","Loop diuretic doses will be up-titrated based on post-diuretic urine sodium concentration measured using a point-of-care sensor. Insufficient natriuresis (\\\u003C80 mmol\u002FL) will prompt dose escalation according to a predefined algorithm.",[13],"Behavioral: Natriuresis-Guided Up-Titration",{"label":15,"type":6,"description":16,"interventionNames":17},"Group 1 Standard of Care (Up-Titration Control)","Participants will receive usual clinical management of diuretics at the discretion of their treating physician without access to urine sodium-guided titration.",[18],"Other: Standard care",{"label":20,"type":10,"description":21,"interventionNames":22},"Group 2 Natriuresis-Guided Down-Titration","Loop diuretic doses will be reduced based on urine sodium levels. If urine sodium ≥80 mmol\u002FL, the current dose will be maintained; if \\\u003C80 mmol\u002FL, dose will be reduced according to a predefined algorithm. Re-titration criteria include symptomatic weight gain \\>2 kg in one week.",[23],"Behavioral: Natriuresis-Guided Down-Titration",{"label":25,"type":6,"description":26,"interventionNames":27},"Group 2 Standard Care (Down-Titration Control)","Participants will receive usual care without urine sodium-guided adjustments.",[18],{"label":29,"type":6,"description":30,"interventionNames":31},"Group 3 Observational Cohort","Participants who do not meet inclusion criteria for Groups 1 or 2 will undergo baseline urine sodium assessment and routine clinical follow-up. No study-directed titration will occur.",[32],"Other: Observational Follow-up",[34,40,44,47],{"type":35,"name":36,"description":37,"armGroupLabels":38,"otherNames":39},"BEHAVIORAL","Natriuresis-Guided Up-Titration","Diuretic dose and regimen will be increased based on post-diuretic urine sodium concentration measured by a point-of-care sensor. Insufficient natriuresis (\\\u003C80 mmol\u002FL) will prompt dose escalation using a predefined algorithm.",[9],null,{"type":6,"name":41,"description":42,"armGroupLabels":43,"otherNames":39},"Standard care","Participants will receive usual clinical management of loop diuretics at the discretion of the treating physician, without natriuresis-guided adjustment.",[15,25],{"type":35,"name":45,"description":21,"armGroupLabels":46,"otherNames":39},"Natriuresis-Guided Down-Titration",[20],{"type":6,"name":48,"description":30,"armGroupLabels":49,"otherNames":39},"Observational Follow-up",[29],[51],{"name":52,"role":53,"phone":54,"phoneExt":55,"email":56},"Natalie Bloch, MD","CONTACT","604-875-4111","66065","natalie.blochisenberg@vch.ca",[58],{"facility":59,"status":60,"city":61,"state":62,"zip":39,"country":63,"countryCode":64,"cosmosGeoPoint":65,"geoPoint":70,"contacts":71},"Vancouver General Hospital","RECRUITING","Vancouver","British Columbia","Canada","CA",{"type":66,"coordinates":67},"Point",[68,69],-123.11934,49.24966,{"lat":69,"lon":68},[72,75,78],{"name":73,"role":53,"phone":54,"phoneExt":55,"email":74},"Amitai Segev, MD","asegev@yahoo.com",{"name":76,"role":77,"phone":39,"phoneExt":39,"email":39},"Nathaniel Hawkins, MD","PRINCIPAL_INVESTIGATOR",{"name":73,"role":79,"phone":39,"phoneExt":39,"email":39},"SUB_INVESTIGATOR",{"type":77,"investigatorFullName":81,"investigatorTitle":82,"investigatorAffiliation":5,"oldNameTitle":39,"oldOrganization":39},"Nathaniel Hawkins","Clinical Associate Professor","100621379","spot-analysis-of-natriuresis-to-guide-up--or-down-titration-of-diuretic-therapy-in-ambulatory-patients-with-chronic-heart-failure-100621379",false,"NCT07369856","Spot Analysis of Natriuresis to Guide up- or Down-titration of Diuretic Therapy in Ambulatory Patients With Chronic Heart Failure","Spot Analysis of Natriuresis to Guide up- or Down-titration of Diuretic Therapy in Ambulatory Patients With Chronic Heart Failure (SAND-HF)","SAND-HF","Inclusion Criteria:\n\n* Age ≥18 years\n* Diagnosis of heart failure according to the Universal Definition\n* Use of loop diuretics\n* Residing in VCH or PHC regions\n\nGroup-specific inclusion:\n\nGroup 1: Congestion score ≥5 OR objective congestion; stable furosemide ≥1 week Group 2: NYHA I-II; congestion score \\\u003C5; no recent HF hospitalization; stable furosemide ≥1 month Group 3: First 100 eligible patients not meeting criteria for Groups 1 or 2\n\nExclusion Criteria:\n\n* eGFR \\\u003C20 mL\u002Fmin\u002F1.73m²\n* Renal replacement therapy\n* High-risk clinical status requiring hospitalization\n* Inability to consent or perform required urine sampling","ALL","18 Years",{"count":94,"type":95},300,"ESTIMATED","INTERVENTIONAL",[98],"NA","Heart failure is a chronic condition that causes congestion and frequent hospitalizations. Diuretic doses are usually adjusted based on clinical judgment without an objective measure of response. This study will test the feasibility of using point-of-care urine sodium measurements to guide up-titration or down-titration of loop diuretics in ambulatory patients with heart failure.\n\nParticipants will be assigned to one of three groups based on congestion status. Groups 1 and 2 will be randomized 1:1 to natriuresis-guided therapy or standard care. Group 3 will be observational. The 90-day pilot trial will evaluate feasibility, clinical outcomes, and usability of a urine sodium-guided titration strategy.",[101,102],"Heart Failure","Diuretics",[104,105,106],"heart failure","diuretics","management","2026-03-23",{"date":109,"type":110},"2026-03-27","ACTUAL",{"date":112,"type":110},"2025-11-04",{"date":114,"type":95},"2027-12-30",{"name":5,"class":6},1]