Hypertonic saline plus i.v. furosemide improve renal safety profile and clinical outcomes in acute decompensated heart failure

Abstract

HSS as an adjunct to i.v. furosemide for diuretic-resistant CHF patients led to a better renal safety profile and improved clinical endpoints such as mortality and heart failure-related hospitalizations.

RETRACTED: Vasopressin Receptor Antagonists for the Correction of Hyponatremia in Chronic Heart Failure: An Underutilized Therapeutic Option in Current Clinical Practice?

“…HSS plus a loop diuretic such as furosemide should be complemented by the administration of KCl to replenish the K + losses induced by the diuretic [19,20]. In addition, in hypervolemic hyponatremia that is unresponsive to diuretics, intermittent or continuous hemodiafiltration may be necessary in order to reduce the volume of ECF while hyponatremia is corrected with i.v.…”

Comparison of three diuretic treatment strategies for patients with acute decompensated heart failure

“…Moreover, it was shown in many studies that HSS facilitates heart failure compensation with more effective diuresis and less deterioration in renal function [11,12,24,25]. Administration of HSS with high doses of loop diuretics reduces neurohormonal stimulation as well as diuretic-related renal dysfunction [26]. However, administration of HSS without concomitant intravenous furosemide may have unfavorable effects.…”

“…The efficacy of various concentrations of HSS has been evaluated in patients with heart failure [26,29,30]. It was reported that infusion of 7.5 % NaCl solution resulted in vasodilatation and increased coronary and renal blood flow in experimental shock models [31,32].…”

“…In our trial, the change in renal function showed a nonsignificant trend toward improvement in the bI group. Small volumes of HSS plus loop diuretic can be a very effective and valuable method for reducing the potential detrimental effects of neurohormonal stimulation and deterioration of renal function [26]. HSS infusion causes a quick increase in extracellular NaCl concentration, which results in an increase in osmotic pressure, rapid fluid mobilization into the vascular compartment, and improved renal blood flow [24,33,34].…”

Worsening of proteinuria caused by combination therapy of hypertonic saline and low-dose furosemide for treatment of acute decompensated heart failure with overt diabetic nephropathy

“…This therapy was used mostly in cases of diuretic resistance, or in cases of refractory heart failure [1]. This therapy is also thought to be renoprotective since it preserved renal filtration function, as assessed by a significantly smaller increase in serum creatinine levels during the hospital stay of patients who were administered the combination therapy compared to patients given furosemide alone [2].…”