{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T19:19:33Z","timestamp":1754162373573,"version":"3.41.2"},"reference-count":8,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T00:00:00Z","timestamp":1753833600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p>Heart failure (HF) management commonly relies on diuretics, yet standard fixed-dose regimens fail to adjust for daily fluid fluctuations, often leading to suboptimal management. Current tools lack the real-time precision needed to adjust therapy in response to these fluctuations. Bioelectrical impedance analysis (BIA) is a tool that can potentially provide personalized guidance for adjusting diuretic therapy, but its daily clinical utility remains limited. We present the case of an 85-year-old patient with chronic HF who performed daily BIA measurements to guide diuretics administration over 1,201 days. The patient adjusted diuretic administration in response to rises in body weight and extracellular water to total body water (ECW\/TBW) ratio, indicating fluid accumulation beyond his baseline variability. The patient maintained full adherence to daily BIA monitoring. Despite using diuretics on only 9.2% of the days, fluid balance remained stable with no changes in cardiac, renal, or electrolyte parameters. Fluid retention resolved within 24\u2005h following tailored diuretic intervention. Additionally, daily BIA facilitated differentiation between fluid-driven from non-fluid-driven weight changes, improving informed decision-making. This case demonstrates that a daily BIA-guided, patient-led diuretic regimen was feasible and effective in maintaining fluid stability with minimal diuretic use. This approach may serve as a personalized self-care model for chronic HF management.<\/jats:p>","DOI":"10.3389\/fcvm.2025.1625554","type":"journal-article","created":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T05:28:31Z","timestamp":1753853311000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Daily water monitoring provides an evidence-based guide for safe and effective use of diuretics\u2014a longitudinal study"],"prefix":"10.3389","volume":"12","author":[{"given":"Susie","family":"Cha","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas W.","family":"Wilmore","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1964","DOI":"10.1056\/nejmra1703100","article-title":"Diuretic treatment in heart failure","volume":"377","author":"Ellison","year":"2017","journal-title":"N Engl J Med"},{"key":"B2","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1002\/ejhf.1369","article-title":"The use of diuretics in heart failure with congestion\u2014a position statement from the Heart Failure Association of the European Society of Cardiology","volume":"21","author":"Mullens","year":"2019","journal-title":"Eur J Heart Fail"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e263","DOI":"10.1016\/j.jacc.2021.12.012","article-title":"2022 AHA\/ACC\/HFSA guideline for the management of heart failure: a report of the American College of Cardiology\/American Heart Association joint committee on clinical practice guidelines","volume":"79","author":"Heidenreich","year":"2022","journal-title":"J Am Coll Cardiol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1093\/ajcn\/54.1.26","article-title":"Estimation of extracellular and total body water by multiple-frequency bioelectrical-impedance measurement","volume":"54","author":"Segal","year":"1991","journal-title":"Am J Clin Nutr"},{"key":"B5","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1038\/ki.2014.207","article-title":"The role of bioimpedance and biomarkers in helping to aid clinical decision-making of volume assessments in dialysis patients","volume":"86","author":"Davies","year":"2014","journal-title":"Kidney Int"},{"key":"B6","doi-asserted-by":"publisher","first-page":"397","DOI":"10.5603\/AIT.2014.0061","article-title":"The use of bio-electrical impedance analysis (BIA) to guide fluid management, resuscitation and deresuscitation in critically ill patients: a bench-to-bedside review","volume":"46","author":"Malbrain","year":"2014","journal-title":"Anaesthesiol Intensive Ther"},{"key":"B7","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1136\/bmj.2.5402.177","article-title":"Code of ethics of the world medical association. 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