An observational study in Acute Heart Failure, sponsored by University of Siena. Recruiting at 4 sites in Italy. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-08-08.
Sponsored by University of Siena · Observational
DiurHF is a prospective, multicenter, observational, study that compares continuous with intermittent infusion of furosemide in patients admitted with a diagnosis of ADHF. Previous pilot study design was planned to anticipate a larger multicenter trial able to definitively evaluate the optimal loop diuretic use strategy in patients with ADHF.
The use of intravenous loop diuretics is a cornerstone of therapy for acutely decompensated heart failure (ADHF); significant concerns have been raised regarding risks and benefits of loop diuretics, particularly about dosage and administration regimen.
Recent guidelines recommend the use of these drugs to reduce left ventricular filling pressure, avoid pulmonary edema, and alleviate peripheral fluid retention.
Some studies have provided guidelines for the administration of these drugs in clinical practice, but data interpretation remains challenging due to the frequent exclusion of patients with kidney disease from major ADHF clinical trials. Therefore, it is not clear if continuous infusion is better than intermittent boluses in terms of decongestion, maintenance of renal filtration function and prognosis.
On the other hand, continuous administration should provide a more constant delivery of the drug into the tubule, potentially reducing these phenomena.
The aim of the study is to evaluate the better loop diuretic intravenous administration in terms of renal function, congestion signs, BNP and outcome.
6,331 studies on the registry are indexed under Heart Failure; 1,396 are open to participants now.
This study's planned enrollment of 370 is above the median of 200 across 1,983 observational studies indexed under Heart Failure.
Browse Heart Failure studies →University of Siena is the lead sponsor of 65 studies on the registry; 15 are open to participants now.
Counted across the registry records on this site, refreshed daily.
patients who met diagnostic criteria for ADHF, independently from systolic function by exhibiting: at least one symptom at rest between dyspnea, orthopnea, peripheral edema and major fatigue; and at least two clinical signs including rales, pulmonary congestion on chest radiography, jugular vein dilatation and a third heart sound. An elevation in blood BNP >100 pg/ml was considered supportive for a diagnosis of ADHF
Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
ADHF: Acute Decompensated Heart Failure; BNP: B-type Natriuretic Peptide; IV: IntraVenous; : Left Ventricular Ejection Fraction.
Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.
LVEF (left ventricular ejection fraction)
The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
continuous intravenous furosemide infusion
Drug: Continuous Furosemide Infusion
bolus intermittent intravenous furosemide infusion
Drug: Intermittent Furosemide Infusion
Intravenous continuous Furosemide infusion
Also known as: cIV
Intravenous bolus intermittent Furosemide Infusion
Also known as: iIV
Cardiac death and rehospitalization for HF
Number of participant who are affected by cardiovascular death or rehospitalization within 180 days from discharge.
Time frame: 180 days
length of hospital stay (days)
evaluation of length of hospital stay (days) in the two groups
Time frame: From date of randomization until the discharge (7-12 days)
Inotropes agents
Need to use inotropes agents during the treatment
Time frame: From date of randomization until the discharge (7-12 days)
hypertonic saline solution
need to use hypertonic saline solution during the treatment
Time frame: From date of randomization until the discharge (7-12 days)
Acute kidney injury
changes of renal function in terms of creatinine and estimated glomerular filtration rate (eGFR) comparing continuous vs intermittent administration
Time frame: From date of randomization until the discharge (7-12 days)
Body weight changes
Body weight changes in two groups from the admission to discharge
Time frame: from admission to discharge (7-12 days)
Diuresis
mean urine output in two groups from the admission to discharge
Time frame: from admission to discharge (7-12 days)
BNP changes
mean paired changes of B-type natriuretic peptide (BNP) in the two groups during hospitalization.
Time frame: From date of randomization until the discharge (7-12 days)
BUN changes
mean paired changes of blood urea nitrogen (BUN) in the two groups during hospitalization.
Time frame: From date of randomization until the discharge (7-12 days)
Reduction of edema
Evaluation of edema regression (or not) after treatment in the two groups.
Time frame: From date of randomization until the discharge (7-12 days)
Reduction of dyspnea
Evaluation of dyspnea scale reduction (or not) after treatment in the two groups.
Time frame: From date of randomization until the discharge (7-12 days)
Regression of pulmonary congestion
Evaluation of pulmonary congestion regression (or not) after treatment in the two groups, considering Chest X-ray at admission and at discharge
Time frame: From date of randomization
Diuretic efficiency: (Weight loss/days of infusion)/ (Mean daily furosemide dosage/40 mg of furosemide)
Evaluation of persistence of congestion (or not) and incidence of AKI (or not) according to quartiles of diuretic efficiency.
Time frame: From hospital admission until the discharge (7-12 days)
High (> 125 mg/die) versus low (<125 mg/die) intravenous diuretic dosage
Number of patients with high in-hospital diuretic dosage who were affected by adverse outcome.
Time frame: 180 days
Diuretic efficiency: (Weight loss/days of infusion)/ (Mean daily furosemide dosage/40 mg of furosemide)
Number of patients (according quartiles of diuretic efficiency) who were affected by adverse outcome.
Time frame: 180 days
Plan to share: No
Started Dec 2015 (actual). Primary completion is estimated for Jan 2028, 145 months after the start.
Of 793 non-industry observational studies under Heart Failure, half reached primary completion within 45 months of starting (the median), counting those still running; a quarter within 23 and three quarters within 99. This study's planned 145 months is above that.
Counting every sponsor, half of 975 studies reached it within 41 months; a quarter within 23 and three quarters within 89.
How these figures are worked out, and which studies are left out of them.
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University of Siena