Urinary sodium to manage patients with acute heart failure

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Heart failure is one of the most common causes of hospital admissions globally. Typical signs and symptoms of acute heart failure (HF) are mostly related to congestion, driven by sodium retention and subsequent fluid retention. Removal of excess sodium and water (decongestive therapy) by diuretics is the cornerstone of treatment. Assessing the efficacy of treatment by current methods, such as weight loss and net fluid balance is very challenging. Diuretics act by diminishing sodium reabsorption at different sites in the kidney, thereby increasing urinary sodium and water loss. Hence, a limited number of small prospective observational studies have suggested the role of urinary sodium content (UNa) as a tool to rapidly assess the response to decongestive therapy and to estimate future outcomes. Aims and Objectives: 1. To assess the feasibility and efficacy of adjusting diuretic therapy using UNa in patients presenting with AHF in an Australian metropolitan hospital 2. To evaluate the safety of this method 3. To determine if UNa guided diuretic therapy improves clinical outcomes Design: A prospective, randomized controlled trial. Study population 60 patients >18 years old admitted under cardiology team with the primary diagnosis of AHF, requiring intravenous diuretics. Recruitment period: 6month. Expected number: 60 patients.