{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T16:04:23Z","timestamp":1793289863974,"version":"4.5.0"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2014,9]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>\n              The urinary composition, including sodium (Na\n              <jats:sup>+<\/jats:sup>\n              ) and chloride (Cl\n              <jats:sup>\u2212<\/jats:sup>\n              ) concentrations, might provide useful information in addition to urine output during decongestive treatment in heart failure.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              Consecutive patients with heart failure (n=61), ejection fraction \u226445%, worsening symptoms, and scheduled treatment with intravenous loop diuretics were included. Patients received protocol-driven therapy until complete decongestion, assessed clinically and by echocardiography. Three consecutive 24-hour urinary collections were performed. With 2 mg (1\u20134 mg), 1 mg (0\u20132 mg), and 1 mg (0\u20131 mg) bumetanide administered in bolus during consecutive 24-hour intervals, in addition to combinational diuretic therapy in \u224870% and both oral spironolactone and vasodilators in \u224890%, euvolemia was reached, often within 24 hours. Urine output was higher during the first when compared with the second or third 24-hour interval (2700 versus 1550 or 1375 mL, respectively;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), but this was no longer significant after correction for diuretic dose (\n              <jats:italic>P<\/jats:italic>\n              =0.263), indicating preserved diuretic efficiency during the study. In contrast, urinary Na\n              <jats:sup>+<\/jats:sup>\n              and Cl\n              <jats:sup>\u2212<\/jats:sup>\n              excretion both decreased significantly, even after correction for diuretic dose (\n              <jats:italic>P<\/jats:italic>\n              =0.040 and 0.004, respectively), leading to decreasing urinary concentrations with progressive decongestion. After reaching euvolemia, lower urinary Na\n              <jats:sup>+<\/jats:sup>\n              \/Cr and Cl\n              <jats:sup>\u2212<\/jats:sup>\n              \/Cr ratios were both associated with urine output \u22641500 mL (area under the curve, 0.830 and 0.826, respectively;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001 for both), in contrast to plasma N-terminal pro\u2013B-type natriuretic peptide levels that were not (area under the curve, 0.515;\n              <jats:italic>P<\/jats:italic>\n              =0.735)\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>\n              The urinary composition during progressive decongestion in heart failure with reduced ejection fraction is characterized by a drop in urinary Na\n              <jats:sup>+<\/jats:sup>\n              and Cl\n              <jats:sup>\u2212<\/jats:sup>\n              concentrations. The urinary Na\n              <jats:sup>+<\/jats:sup>\n              \/Cr or Cl\n              <jats:sup>\u2212<\/jats:sup>\n              \/Cr ratio might provide insightful information to titrate diuretic therapy.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circheartfailure.114.001377","type":"journal-article","created":{"date-parts":[[2014,7,19]],"date-time":"2014-07-19T05:09:16Z","timestamp":1405746556000},"page":"766-772","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":86,"title":["Urinary Composition During Decongestive Treatment in Heart Failure With Reduced Ejection Fraction"],"prefix":"10.1161","volume":"7","author":[{"given":"Frederik H.","family":"Verbrugge","sequence":"first","affiliation":[{"name":"From the Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (F.H.V., P.N., M.D., W.M.); Doctoral School for Medicine and Life Sciences (F.H.V., P.N.) and Biomedical Research Institute, Faculty of Medicine and Life Sciences (J.P., W.M.), Hasselt University, Diepenbeek, Belgium; Department of Laboratory Medicine, Ziekenhuis Oost-Limburg, Genk, Belgium (J.P.); and Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, OH (W.H.W.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra","family":"Nijst","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (F.H.V., P.N., M.D., W.M.); Doctoral School for Medicine and Life Sciences (F.H.V., P.N.) and Biomedical Research Institute, Faculty of Medicine and Life Sciences (J.P., W.M.), Hasselt University, Diepenbeek, Belgium; Department of Laboratory Medicine, Ziekenhuis Oost-Limburg, Genk, Belgium (J.P.); and Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, OH (W.H.W.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Dupont","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (F.H.V., P.N., M.D., W.M.); Doctoral School for Medicine and Life Sciences (F.H.V., P.N.) and Biomedical Research Institute, Faculty of Medicine and Life Sciences (J.P., W.M.), Hasselt University, Diepenbeek, Belgium; Department of Laboratory Medicine, Ziekenhuis Oost-Limburg, Genk, Belgium (J.P.); and Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, OH (W.H.W.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joris","family":"Penders","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (F.H.V., P.N., M.D., W.M.); Doctoral School for Medicine and Life Sciences (F.H.V., P.N.) and Biomedical Research Institute, Faculty of Medicine and Life Sciences (J.P., W.M.), Hasselt University, Diepenbeek, Belgium; Department of Laboratory Medicine, Ziekenhuis Oost-Limburg, Genk, Belgium (J.P.); and Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, OH (W.H.W.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.H. Wilson","family":"Tang","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (F.H.V., P.N., M.D., W.M.); Doctoral School for Medicine and Life Sciences (F.H.V., P.N.) and Biomedical Research Institute, Faculty of Medicine and Life Sciences (J.P., W.M.), Hasselt University, Diepenbeek, Belgium; Department of Laboratory Medicine, Ziekenhuis Oost-Limburg, Genk, Belgium (J.P.); and Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, OH (W.H.W.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilfried","family":"Mullens","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (F.H.V., P.N., M.D., W.M.); Doctoral School for Medicine and Life Sciences (F.H.V., P.N.) and Biomedical Research Institute, Faculty of Medicine and Life Sciences (J.P., W.M.), Hasselt University, Diepenbeek, Belgium; Department of Laboratory Medicine, Ziekenhuis Oost-Limburg, Genk, Belgium (J.P.); and Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, OH (W.H.W.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2004.08.005"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10741-005-6127-6"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2006.07.073"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.933275"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/circheartfailure.111.963413"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejheart.2007.07.011"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2010.04.004"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hfs105"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0b013e31829e8776"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11897-013-0174-4"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.35"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0894-7317(89)80014-8"},{"key":"e_1_3_4_14_2","first-page":"450","article-title":"Response of the kidney to furosemide. 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J Lab Clin Med. 1983;102:450\u2013458.","journal-title":"J Lab Clin Med"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1987.20"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1159\/000082314"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/14.suppl_4.39"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.100.12.1311"}],"container-title":["Circulation: Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCHEARTFAILURE.114.001377","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T01:13:33Z","timestamp":1715562813000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCHEARTFAILURE.114.001377"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,9]]},"references-count":17,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2014,9]]}},"alternative-id":["10.1161\/CIRCHEARTFAILURE.114.001377"],"URL":"https:\/\/doi.org\/10.1161\/circheartfailure.114.001377","relation":{},"ISSN":["1941-3289","1941-3297"],"issn-type":[{"value":"1941-3289","type":"print"},{"value":"1941-3297","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,9]]},"assertion":[{"value":"2014-04-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-07-07","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-07-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}