[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-studies-list:{\"conditionNormalized\":\"diuretics\",\"overallStatus\":[\"RECRUITING\",\"AVAILABLE\",\"NOT_YET_RECRUITING\"],\"orderBy\":\"LastUpdateSubmitDate:desc\",\"size\":25,\"offset\":0}":3,"health-study-condition:diuretics":29},{"pageToken":4,"total":5,"offset":6,"count":5,"results":7},null,3,0,[8,49,77],{"id":9,"slug":10,"hasResults":11,"nctId":12,"briefTitle":13,"officialTitle":13,"acronym":14,"eligibilityCriteria":15,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":4,"enrollmentInfo":18,"targetDuration":4,"studyType":21,"phases":22,"briefSummary":24,"conditions":25,"keywords":30,"overallStatus":36,"whyStopped":4,"lastUpdateSubmitDate":37,"lastUpdatePostDateStruct":38,"startDateStruct":41,"completionDateStruct":43,"leadSponsor":45,"locationsCount":48},"100635908","vexus-assessment-and-natriuresis-guided-diuretic-therapy-in-acute-heart-failure-100635908",false,"NCT07558798","Vexus Assessment and Natriuresis-guided Diuretic Therapy in Acute Heart Failure","VANTAGE-HF","Inclusion Criteria:\n\n* Age \\>18 years\n* Hospitalization with AHF, either de novo or worsening of chronic HF\n* Able to provide written informed consent\n* Requirement of intravenous loop diuretic treatment as judged by the treating physician\n\nExclusion Criteria:\n\n* Dyspnea primarily due to non-cardiac causes\n* Advanced renal disease or estimated glomerular filtration rate (eGFR) \\\u003C 20 mL\u002Fmin\u002F1.73m2 at screening or on-going dialysis.\n* Enrollment in another study interfering with the treatment algorithm of the current study\n* Inability to follow the treatment protocol\n* Language barriers requiring the need for an external interpreter\n* Pregnant or nursing (lactating) women\n* Very short life expectancy (\\\u003C30 days)","ALL","18 Years",{"count":19,"type":20},270,"ESTIMATED","INTERVENTIONAL",[23],"NA","This study evaluates whether natriuresis-guided diuretic therapy improves outcomes in patients with acute heart failure (AHF) and severe congestion. All patients hospitalized with AHF will be screened using Venous Excess Ultrasound (VExUS) and randomized 1:1 to either natriuresis-guided escalation of loop diuretics or standard care. The primary endpoint, evaluated in patients with VExUS grade 3 (severe congestion), is a hierarchical composite (win ratio) of 90-day mortality, 90-day rehospitalization, and hospital length of stay. Key secondary endpoints (hierarchical) include (1) difference in win ratio between patients with VExUS 3 versus VExUS 0-2 at hospital admission (assessed by interaction testing and statistically tested only if the primary endpoint is significant) and (2) win ratio (primary endpoint) tested among patients with VExUS 0-2 at hospital admission (statistically tested only if the first key seconday endpoint is significant). Exploratory endpoints include in-hospital clinical, hemodynamic, and biochemical outcomes (mortality, eGFR, NT-proBNP, NYHA class, VExUS score, natriuresis\u002Fdiuresis, and patient-reported dyspnea), associations between congestion markers (VExUS, FibroScan, lung ultrasound, clinical score, and NT-proBNP), as well as quality of life at 90 days, GDMT optimization score at discharge, and long-term time to readmission and mortality assessed through registry linkage.",[26,27,28,29],"Venous Congestion","Heart Failure Acute","VExUS","Diuretics",[31,32,33,34,35],"loop diuretics","heart failure","acute heart failure","vexus","congestion","NOT_YET_RECRUITING","2026-04-23",{"date":39,"type":40},"2026-04-30","ACTUAL",{"date":42,"type":20},"2026-04",{"date":44,"type":20},"2028-06",{"name":46,"class":47},"University Hospital, Akershus","OTHER",2,{"id":50,"slug":51,"hasResults":11,"nctId":52,"briefTitle":53,"officialTitle":54,"acronym":55,"eligibilityCriteria":56,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":4,"enrollmentInfo":57,"targetDuration":4,"studyType":21,"phases":59,"briefSummary":60,"conditions":61,"keywords":63,"overallStatus":66,"whyStopped":4,"lastUpdateSubmitDate":67,"lastUpdatePostDateStruct":68,"startDateStruct":70,"completionDateStruct":72,"leadSponsor":74,"locationsCount":76},"100621379","spot-analysis-of-natriuresis-to-guide-up--or-down-titration-of-diuretic-therapy-in-ambulatory-patients-with-chronic-heart-failure-100621379","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",{"count":58,"type":20},300,[23],"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.",[62,29],"Heart Failure",[32,64,65],"diuretics","management","RECRUITING","2026-03-23",{"date":69,"type":40},"2026-03-27",{"date":71,"type":40},"2025-11-04",{"date":73,"type":20},"2027-12-30",{"name":75,"class":47},"Cardiology Research UBC",1,{"id":78,"slug":79,"hasResults":11,"nctId":80,"briefTitle":81,"officialTitle":81,"acronym":82,"eligibilityCriteria":83,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":4,"enrollmentInfo":84,"targetDuration":4,"studyType":21,"phases":86,"briefSummary":87,"conditions":88,"keywords":95,"overallStatus":66,"whyStopped":4,"lastUpdateSubmitDate":99,"lastUpdatePostDateStruct":100,"startDateStruct":102,"completionDateStruct":104,"leadSponsor":106,"locationsCount":76},"100577562","optimization-of-fluid-balance-guided-by-bioelectrical-impedance-analysis-in-patients-undergoing-continuous-renal-replacement-therapy-in-critical-care-100577562","NCT06799910","Optimization of Fluid Balance Guided by Bioelectrical Impedance Analysis in Patients Undergoing Continuous Renal Replacement Therapy in Critical Care","OBHIMER","Inclusion Criteria:\n\n* Age \\> 18 years\n* The patient was hospitalized in the intensive care unit of Amiens-Picardie University Hospital.\n* Patient with an increase in fluid balance (TBW \\> 5%)\n* Patient receiving continuous veno-venous hemofiltration (CVVH) on a PrismaFlexR or PrisMaxR machine, initiated due to oliguria, potassium level \\> 6.5 mmol\u002FL, urea level \\> 25 mmol\u002FL, or creatinine \\> 300 µmol\u002FL and severe metabolic acidosis (pH \\\u003C 7.2).\n* Hemodynamically stable patient with a mean arterial pressure (MAP) \\> 65 mmHg for more than 4 hours with norepinephrine.\n* Signed consent to participate in the study by the patient or, if unconscious, their legal representative\u002Fnext of kin.\n\nExclusion Criteria:\n\n* Invalid BIA measurements\n* Internal device powered by an electrical current (pacemaker, implantable cardioverter-defibrillator, neurostimulator)\n* Cardiac arrhythmia (atrial fibrillation, atrial flutter) present at the inclusion\n* Chronic dialysis patient\n* Moribund patient\n* The patient is on extracorporeal mechanical support\n* Hemorrhagic shock\n* Pregnant woman\n* Patient under guardianship or conservators.",{"count":85,"type":20},60,[23],"In critical care, hemodynamic instability often requires volume expansion to restore tissue perfusion, increasing fluid balance and TBW, factors associated with higher mortality. Excess fluid leads to organ dysfunction due to venous congestion, making fluid removal crucial. When diuretics fail, RRT, typically through continuous renal replacement therapy (CRRT), is recommended. However, prescribing the correct level of UF is challenging; insufficient UF can worsen edema, while excessive UF risks hemodynamic instability. This pilot, single-center, prospective, interventional, randomized, controlled, open-label study includes two parallel groups: a standard group with UF prescribed by the physician based on clinical and hemodynamic status and an experimental group with UF guided by the extracellular to total body water (ECW\u002FTBWat) ratio measured by BIA. The aim is to determine if ECW\u002FTBW-guided UF improves fluid and TBW reduction over a 72-hour RRT period.",[89,90,91,92,93,29,94],"Congestion","RRT","UF","Bio-impendance Analysis","Fluid Removal","Overload",[96,97,64,98,35,90,91],"bio-impendance analysis","fluid removal","overload","2025-01-28",{"date":101,"type":40},"2025-01-29",{"date":103,"type":40},"2024-09-26",{"date":105,"type":20},"2026-06",{"name":107,"class":47},"Centre Hospitalier Universitaire, Amiens"]