NCT07263035 · Lakeland Regional Health Systems, Inc.
Urine Sodium-Driven Diuretic Adjustment Strategy in Acute Decompensated Heart Failure
(US-DASH)
What this study is about
The goal of this clinical trial is to learn if increasing the dose of diuretics to achieve a higher urine sodium target produces better clinical results when treating patients hospitalized with acute heart failure when compared to lower urine sodium target and the usual treatment. The main questions it aims to answer are: 1.
View original scientific description
The goal of this clinical trial is to learn if increasing the dose of diuretics to achieve a higher urine sodium target produces better clinical results when treating patients hospitalized with acute heart failure when compared to lower urine sodium target and standard of care. The main questions it aims to answer are: 1. Does targeting a higher urine sodium goal achieve greater natriuresis and diuresis? 2. Does targeting a higher urine sodium goal reduce frequency of hospital readmissions? 3. Does targeting a higher urine sodium goal reduce hospital length of stay? Researchers will compare natriuresis-guided arms with standard of care to see if targeting higher natriuresis goals improves significantly over current practice. Participants will submit urine samples at routine intervals after being given diuretics to evaluate urine sodium concentration. If urine sodium is low then diuretic dose will be increased.
Interventions
DRUG
Furosemide intravenous solution
Diuretics will be titrated to achieve a urine sodium concentration of 50 mmol/L
DRUG
Furosemide intravenous solution
Diuretics will be titrated to achieve a urine sodium concentration of 85 mmol/L
DRUG
Furosemide intravenous solution
Standard of care
Primary outcome measures
Natriuresis at 24 hours
Time frame: 24 hours
24-hour natriuresis as measured by urine sodium in a 24-hour urine collection
Who can participate
This study lists these criteria on ClinicalTrials.gov. A study coordinator reviews eligibility during screening — this page does not determine whether you qualify.
Inclusion criteria
- The study will target adults 18 years of age or older admitted to Lakeland Regional Medical Center who:
- Have a primary diagnosis of acute decompensated heart failure, and
- Have at least one of the following signs of hypervolemia:
- Bilateral lower extremity pitting edema
- Jugular venous distension
- Hepatojugular reflex
- Crackles on pulmonary exam, or
- Chest x-ray demonstrating pulmonary edema or pleural effusions
Exclusion criteria
- Admission to the intensive care unit
- Presence of ST-elevated myocardial infarction
- Presence of type 1 non-ST elevated myocardial infarction
- Dyspnea primarily due to non-cardiac cause as judged by the emergency medicine physician or admitting physician
- Use of supplemental oxygen totaling at least 3 L per minute or greater at baseline
- End-stage renal disease per KDIGO criteria
- Dialysis use
Where
- Lakeland, Florida
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Frequently asked questions
What is a clinical trial?
A clinical trial is a research study that tests new medical treatments, drugs, devices, or procedures to determine their safety and effectiveness. Trials are carefully designed and monitored to protect participants while advancing medical knowledge.
Is it safe to participate?
Clinical trials follow strict safety guidelines and ethical standards. Trials must be reviewed and approved, and participants are closely monitored by medical professionals throughout the study. You can withdraw at any time if you choose.
Will I be compensated?
Many clinical trials offer compensation for your time, travel expenses, and inconvenience. The specific compensation varies by study and will be discussed during the screening process. All study-related medical care is typically provided at no cost to participants.
Will I receive a placebo instead of treatment?
When effective treatment exists, participants typically receive either the standard treatment plus the study intervention, or the standard treatment plus placebo. You would not be denied effective care. Placebos are primarily used when no proven treatment is available, or in addition to standard care. Your trial consent form will clearly explain what treatments you may receive.
Can I leave a trial if I change my mind?
Absolutely. Participation in clinical trials is completely voluntary. You have the right to withdraw from the study at any time, for any reason, without penalty or loss of benefits to which you are otherwise entitled.
How long does a clinical trial last?
Trial duration varies widely depending on the study design and purpose. Some trials last just a few weeks, while others may continue for months or years. The study coordinator will provide specific timeline information during your screening call.
Data: ClinicalTrials.gov · synced Apr 9, 2026 · Source of record for eligibility and locations