{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T19:37:59Z","timestamp":1781725079084,"version":"3.54.5"},"reference-count":6,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T00:00:00Z","timestamp":1747699200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Rapid assessment of diuretic efficacy is necessary in the treatment of acute decompensated heart failure. European guidelines advocate for the use of spot urinary sodium measurements, but recent data suggest urinary chloride is the better marker. Laboratory turnaround, however, delays clinical decision\u2010making. We tackle this by using a commercially available chloride urinary dipstick to estimate sodium and measure chloride.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective pilot study involving patients hospitalized at the University of Michigan for acute decompensated heart failure (ADHF) with an indication for intravenous diuresis; patients were eligible for enrollment within 24\u2009h of admission. Patients with end\u2010stage kidney disease or receiving continuous loop diuretic infusions or thiazide\u2010type diuretics were excluded. A spot urine sample was collected after the loop diuretic dose. A chloride dipstick was used, and results were compared against laboratory\u2010obtained measurements of urinary chloride and sodium.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In a total of 22 patients (mean age 62.2\u2009\u00b1\u200911.8\u2009years, 50% female, and LVEF 31.8\u2009\u00b1\u200917.4%), dipstick chloride concentrations correlated highly with laboratory\u2010measured urine chloride (<jats:italic>r<\/jats:italic>\u2009=\u20090.98, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) with slight overestimation across the physiological range and with laboratory\u2010measured urine sodium (<jats:italic>r<\/jats:italic>\u2009=\u20090.86, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), although with greater variation. Dipstick interpretation preceded laboratory results by a median of 136\u2009minutes (IQR 103\u2013170, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The chloride dipstick rapidly and accurately assessed urine chloride almost 2\u2009h faster than traditional laboratory output in patients undergoing diuresis for ADHF. It may be a new tool to evaluate loop diuretic treatment for ADHF. However, more studies are needed to assess its impacts on clinical outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/phar.70026","type":"journal-article","created":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T07:35:59Z","timestamp":1747726559000},"page":"352-355","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Chloride dipstick to rapidly estimate urine sodium during diuresis in acute heart failure"],"prefix":"10.1002","volume":"45","author":[{"given":"Vacha","family":"Shah","sequence":"first","affiliation":[{"name":"Sidney Kimmel Medical College Thomas Jefferson University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Cordwin","sequence":"additional","affiliation":[{"name":"College of Pharmacy University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott L.","family":"Hummel","sequence":"additional","affiliation":[{"name":"VA Ann Arbor Health System  Ann Arbor Michigan USA"},{"name":"Michigan Medicine University of Michigan Health System  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6280-5770","authenticated-orcid":false,"given":"Michael P.","family":"Dorsch","sequence":"additional","affiliation":[{"name":"College of Pharmacy University of Michigan  Ann Arbor Michigan USA"},{"name":"Michigan Medicine University of Michigan Health System  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,20]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2021.09.026"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2024.06.002"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab368"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.15054"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.3429"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnesp.2022.08.011"}],"updated-by":[{"DOI":"10.1002\/phar.70052","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T00:00:00Z","timestamp":1755043200000}}],"container-title":["Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/phar.70026","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T16:16:08Z","timestamp":1761063368000},"score":1,"resource":{"primary":{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/10.1002\/phar.70026"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,20]]},"references-count":6,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1002\/phar.70026"],"URL":"https:\/\/doi.org\/10.1002\/phar.70026","archive":["Portico"],"relation":{},"ISSN":["0277-0008","1875-9114"],"issn-type":[{"value":"0277-0008","type":"print"},{"value":"1875-9114","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,20]]},"assertion":[{"value":"2025-02-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}