{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:31:53Z","timestamp":1768782713756,"version":"3.49.0"},"reference-count":31,"publisher":"S. Karger AG","issue":"2","license":[{"start":{"date-parts":[[2017,1,1]],"date-time":"2017-01-01T00:00:00Z","timestamp":1483228800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2017,1,1]],"date-time":"2017-01-01T00:00:00Z","timestamp":1483228800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiorenal Med"],"published-print":{"date-parts":[[2017]]},"abstract":"<jats:p>&lt;b&gt;&lt;i&gt;Introduction:&lt;\/i&gt;&lt;\/b&gt; The assessment of the amount of urine produced by the dose of administered diuretic has been proposed as the main signal of interest in diuretic responsiveness - diuretic efficiency (DE). The main aim of our study is to determine if a low DE is associated with 180-day all-cause mortality (ACM). &lt;b&gt;&lt;i&gt;Methods:&lt;\/i&gt;&lt;\/b&gt; During a 3-year period, we retrospectively studied patients with acutely decompensated heart failure (ADHF) and respiratory insufficiency admitted to the emergency room of a tertiary university hospital in Porto, Portugal. A total of 170 patients (age 76.2 \u00b1 10.3 years) were included. The outcome of ACM occurred in 43 (25.3%) patients during the 180-day follow-up period. DE was evaluated for a maximum of 3 h after emergency room admission. The lowest DE was defined as \u2264140 mL of diuresis per 40 mg of furosemide equivalents. &lt;b&gt;&lt;i&gt;Results:&lt;\/i&gt;&lt;\/b&gt; No significant differences in age, comorbidities, baseline HF symptoms, or disease-modifying medication were found between the lowest and highest DE groups. The lowest DE group had higher blood urea and lower estimated glomerular filtration rate (eGFR) levels (41.3 \u00b1 24.5 vs. 56.7 \u00b1 23.2 mL\/min\/1.73 m&lt;sup&gt;2&lt;\/sup&gt;, &lt;i&gt;p&lt;\/i&gt; &lt; 0.001). The patients with the lowest DE had significantly higher rates of ACM during the 180-day follow-up, even after adjustment for other clinically relevant variables: hazard ratio (HR) [95% CI] = 2.31 [1.16-4.58], &lt;i&gt;p&lt;\/i&gt; = 0.016. The lowest diuresis (\u2264300 mL) and the highest intravenous furosemide dose (&gt;80 mg) alone were not significantly associated with the outcome. After adjustment for N-terminal prohormone of brain natriuretic peptide, the association between the lowest DE and the outcome lost strength (HR [95% CI] = 1.53 [0.75-3.13], &lt;i&gt;p&lt;\/i&gt; = 0.240). &lt;b&gt;&lt;i&gt;Conclusion:&lt;\/i&gt;&lt;\/b&gt; A low DE (\u2264140 mL\/40 mg of furosemide) in the first 3 h after an ADHF episode was associated with increased mid-term mortality rates.<\/jats:p>","DOI":"10.1159\/000455903","type":"journal-article","created":{"date-parts":[[2017,1,20]],"date-time":"2017-01-20T22:02:57Z","timestamp":1484949777000},"page":"137-149","source":"Crossref","is-referenced-by-count":13,"title":["Lack of Diuretic Efficiency (but Not Low Diuresis) Early in An Acutely Decompensated Heart Failure Episode Is Associated with Increased 180-Day Mortality"],"prefix":"10.1159","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2304-6138","authenticated-orcid":false,"given":"Jo\u00e3o 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Ricardo","sequence":"additional","affiliation":[]},{"given":"Tiago","family":"Almeida","sequence":"additional","affiliation":[]},{"given":"Alexandre","family":"Rola","sequence":"additional","affiliation":[]},{"given":"Faiez","family":"Zannad","sequence":"additional","affiliation":[]},{"given":"Patrick","family":"Rossignol","sequence":"additional","affiliation":[]},{"given":"Irene","family":"Arag\u00e3o","sequence":"additional","affiliation":[]}],"member":"127","published-online":{"date-parts":[[2017,1,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2004.08.005"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2006.09.011"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1210357"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.74"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1517\/14656566.2013.808332"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-013-0588-8"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2005.12.072"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hfr121"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.289"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hfs090"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.113.000895"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs104"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hft095"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2014.03.006"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejheart.2007.07.011"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1159\/000164149"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu065"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.01.052"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2008.01.015"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2015.07.007"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1005419"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2014.08.016"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1097\/MCC.0000000000000134"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2015.07.006"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hft100"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000144310.04433.BE"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2013.08.711"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv273"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1177\/2048872615581501"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1177\/2048872614560504"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-150-9-200905050-00006"}],"container-title":["Cardiorenal 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