{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T01:08:35Z","timestamp":1790816915187,"version":"4.1.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2022,1,6]],"date-time":"2022-01-06T00:00:00Z","timestamp":1641427200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Heart Fail"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Insufficient diuretic response frequently occurs in patients admitted for acute heart failure (HF) and is associated with worse clinical outcomes. Recent studies have shown that measuring natriuresis early after hospital admission could reliably identify patients with a poor diuretic response during hospitalization who might require enhanced diuretic treatment. This study will test the hypothesis that natriuresis\u2010guided therapy in patients with acute HF improves natriuresis and clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The Pragmatic Urinary Sodium\u2010based treatment algoritHm in Acute Heart Failure (PUSH\u2010AHF) is a pragmatic, single\u2010centre, randomized, controlled, open\u2010label study, aiming to recruit 310 acute HF patients requiring treatment with intravenous loop diuretics. Patients will be randomized to natriuresis\u2010guided therapy or standard of care. Natriuresis will be determined at set time points after initiation of intravenous loop diuretics, and treatment will be adjusted based on the urinary sodium levels in the natriuresis\u2010guided group using a pre\u2010specified stepwise approach of increasing doses of loop diuretics and the initiation of combination diuretic therapy. The co\u2010primary endpoint is 24\u2010h urinary sodium excretion after start of loop diuretic therapy and a combined endpoint of all\u2010cause mortality or first HF rehospitalization at 6\u00a0months. Secondary endpoints include 48\u2010 and 72\u2010h sodium excretion, length of hospital stay, and percentage change in N\u2010terminal pro brain natriuretic peptide at 48 and 72\u2009h.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The PUSH\u2010AHF study will investigate whether natriuresis\u2010guided therapy, using a pre\u2010specified stepwise diuretic treatment approach, improves natriuresis and clinical outcomes in patients with acute HF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.2385","type":"journal-article","created":{"date-parts":[[2021,11,18]],"date-time":"2021-11-18T00:45:50Z","timestamp":1637196350000},"page":"385-392","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":69,"title":["Natriuresis\u2010guided therapy in acute heart failure: rationale and design of the\n                    <scp>Pragmatic Urinary Sodium\u2010based treatment algoritHm<\/scp>\n                    in\n                    <scp>Acute Heart Failure<\/scp>\n                    (\n                    <scp>PUSH\u2010AHF<\/scp>\n                    ) trial"],"prefix":"10.1093","volume":"24","author":[{"given":"Jozine M.","family":"ter Maaten","sequence":"first","affiliation":[{"name":"University of Groningen, Department of Cardiology University Medical Centre Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iris E.","family":"Beldhuis","sequence":"additional","affiliation":[{"name":"University of Groningen, Department of Cardiology University Medical Centre Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"van der Meer","sequence":"additional","affiliation":[{"name":"University of Groningen, Department of Cardiology University Medical Centre Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan A.","family":"Krikken","sequence":"additional","affiliation":[{"name":"University of Groningen, Department of Cardiology University Medical Centre Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenifer E.","family":"Coster","sequence":"additional","affiliation":[{"name":"University of Groningen, Department of Cardiology University Medical Centre Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wybe","family":"Nieuwland","sequence":"additional","affiliation":[{"name":"University of Groningen, Department of Cardiology University Medical Centre Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk J.","family":"van Veldhuisen","sequence":"additional","affiliation":[{"name":"University of Groningen, Department of Cardiology University Medical Centre Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriaan A.","family":"Voors","sequence":"additional","affiliation":[{"name":"University of Groningen, Department of Cardiology University Medical Centre Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Damman","sequence":"additional","affiliation":[{"name":"University of Groningen, Department of Cardiology University Medical Centre Groningen  Groningen The 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