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Effects of limiting fluid intake on clinical and laboratory outcomes in patients with heart failure. Results of a meta-analysis of randomized controlled trials.
Herz. 2016 Feb; 41(1):63-75.HERZ

Abstract

BACKGROUND

The guidelines of the Scientific Societies of Cardiology recommend limiting fluid intake as a nonpharmacological measure for the management of chronic heart failure (HF). However, many patients with HF may suffer from severe thirst. A meta-analysis was performed to evaluate the effect of limiting fluid consumption based on various clinical and laboratory outcomes in patients with chronic HF.

METHODS

Only randomized controlled trials comparing liberal and restricted fluid oral intake in patients with HF were included. Primary outcomes were HF hospitalizations and all-cause mortality. Secondary outcomes were the sensation of thirst, the duration of therapy with intravenous diuretics, and the serum levels of creatinine, sodium, and B-type natriuretic peptide (BNP).

RESULTS

Six studies met the inclusion criteria. Significant heterogeneity was detected for the majority of outcomes. In 5 studies, patients with restricted fluid intake compared to patients with free consumption of beverages had similar rehospitalization and mortality rates. There were no differences regarding patients' sense of thirst (4 studies), duration of intravenous diuretic treatment (2 studies), serum creatinine levels (5 studies), and serum sodium levels (5 studies). Serum BNP levels were significantly higher in the group with free fluid intake (4 studies).

CONCLUSION

In patients with HF, liberal fluid consumption does not seem to exert an unfavorable impact on HF rehospitalizations or all-cause mortality. Further randomized controlled trials are warranted to definitively confirm the present findings.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

De Vecchis R
Cardiology Unit, Presidio Sanitario Intermedio "Elena d'Aosta", via P.Gaurico 21, 80125, Napoli, Italy. devecchis.erre@virgilio.it.
Baldi C
Heart Department, Interventional Cardiology, A.O.U. "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy.
Cioppa C
Cardiology Unit, Presidio Sanitario Intermedio "Elena d'Aosta", via P.Gaurico 21, 80125, Napoli, Italy.
Giasi A
Cardiology Unit, Presidio Sanitario Intermedio "Elena d'Aosta", via P.Gaurico 21, 80125, Napoli, Italy.
Fusco A
Cardiology Unit, Presidio Sanitario Intermedio "Elena d'Aosta", via P.Gaurico 21, 80125, Napoli, Italy.

MeSH

AdultAgedAged, 80 and overClinical Laboratory TechniquesDiureticsFemaleFluid TherapyHeart FailureHospitalizationHumansMaleMiddle AgedPrevalenceRandomized Controlled Trials as TopicRisk FactorsSurvival RateThirstTreatment OutcomeYoung Adult

Pub Type(s)

Journal Article
Meta-Analysis
Review

Language

eng

PubMed ID

26292805

Citation

De Vecchis, R, et al. "Effects of Limiting Fluid Intake On Clinical and Laboratory Outcomes in Patients With Heart Failure. Results of a Meta-analysis of Randomized Controlled Trials." Herz, vol. 41, no. 1, 2016, pp. 63-75.
De Vecchis R, Baldi C, Cioppa C, et al. Effects of limiting fluid intake on clinical and laboratory outcomes in patients with heart failure. Results of a meta-analysis of randomized controlled trials. Herz. 2016;41(1):63-75.
De Vecchis, R., Baldi, C., Cioppa, C., Giasi, A., & Fusco, A. (2016). Effects of limiting fluid intake on clinical and laboratory outcomes in patients with heart failure. Results of a meta-analysis of randomized controlled trials. Herz, 41(1), 63-75. https://doi.org/10.1007/s00059-015-4345-9
De Vecchis R, et al. Effects of Limiting Fluid Intake On Clinical and Laboratory Outcomes in Patients With Heart Failure. Results of a Meta-analysis of Randomized Controlled Trials. Herz. 2016;41(1):63-75. PubMed PMID: 26292805.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of limiting fluid intake on clinical and laboratory outcomes in patients with heart failure. Results of a meta-analysis of randomized controlled trials. AU - De Vecchis,R, AU - Baldi,C, AU - Cioppa,C, AU - Giasi,A, AU - Fusco,A, Y1 - 2015/08/21/ PY - 2015/04/26/received PY - 2015/07/09/accepted PY - 2015/07/09/revised PY - 2015/8/22/entrez PY - 2015/8/22/pubmed PY - 2016/12/15/medline KW - Cardiovascular outcomes KW - Dehydration KW - Heart failure KW - Thirst KW - Water intake SP - 63 EP - 75 JF - Herz JO - Herz VL - 41 IS - 1 N2 - BACKGROUND: The guidelines of the Scientific Societies of Cardiology recommend limiting fluid intake as a nonpharmacological measure for the management of chronic heart failure (HF). However, many patients with HF may suffer from severe thirst. A meta-analysis was performed to evaluate the effect of limiting fluid consumption based on various clinical and laboratory outcomes in patients with chronic HF. METHODS: Only randomized controlled trials comparing liberal and restricted fluid oral intake in patients with HF were included. Primary outcomes were HF hospitalizations and all-cause mortality. Secondary outcomes were the sensation of thirst, the duration of therapy with intravenous diuretics, and the serum levels of creatinine, sodium, and B-type natriuretic peptide (BNP). RESULTS: Six studies met the inclusion criteria. Significant heterogeneity was detected for the majority of outcomes. In 5 studies, patients with restricted fluid intake compared to patients with free consumption of beverages had similar rehospitalization and mortality rates. There were no differences regarding patients' sense of thirst (4 studies), duration of intravenous diuretic treatment (2 studies), serum creatinine levels (5 studies), and serum sodium levels (5 studies). Serum BNP levels were significantly higher in the group with free fluid intake (4 studies). CONCLUSION: In patients with HF, liberal fluid consumption does not seem to exert an unfavorable impact on HF rehospitalizations or all-cause mortality. Further randomized controlled trials are warranted to definitively confirm the present findings. SN - 1615-6692 UR - https://www.unboundmedicine.com/medline/citation/26292805/Effects_of_limiting_fluid_intake_on_clinical_and_laboratory_outcomes_in_patients_with_heart_failure__Results_of_a_meta_analysis_of_randomized_controlled_trials_ DB - PRIME DP - Unbound Medicine ER -