2024
The utility of urine sodium–guided diuresis during acute decompensated heart failure
Siddiqi H, Cox Z, Stevenson L, Damman K, ter Maaten J, Bales B, Han J, Ivey-Miranda J, Lindenfeld J, Miller K, Ooi H, Rao V, Schlendorf K, Storrow A, Walsh R, Wrenn J, Testani J, Collins S. The utility of urine sodium–guided diuresis during acute decompensated heart failure. Heart Failure Reviews 2024, 29: 1161-1173. PMID: 39128947, PMCID: PMC11455821, DOI: 10.1007/s10741-024-10424-8.Peer-Reviewed Original ResearchAcute decompensated heart failureDecompensated heart failureHeart failureClinical trialsUrine sodium excretionObservational cohort studyRandomized clinical trialsAdequate decongestionDiuretic strategySodium excretionUrine chemistryCohort studyTitration strategyUrineDiuretic titrationAdverse effectsDiuresisDecongestionPatientsUsual careEvidence gapsTrialsTherapyFailure
2021
Compensatory post-diuretic renal sodium reabsorption is not a dominant mechanism of diuretic resistance in acute heart failure
Cox ZL, Rao VS, Ivey-Miranda JB, Moreno-Villagomez J, Mahoney D, Ponikowski P, Biegus J, Turner JM, Maulion C, Bellumkonda L, Asher JL, Parise H, Wilson PF, Ellison DH, Wilcox CS, Testani JM. Compensatory post-diuretic renal sodium reabsorption is not a dominant mechanism of diuretic resistance in acute heart failure. European Heart Journal 2021, 42: 4468-4477. PMID: 34529781, PMCID: PMC8599022, DOI: 10.1093/eurheartj/ehab620.Peer-Reviewed Original ResearchConceptsAcute decompensated heart failureSpontaneous natriuresisDiuretic resistanceHeart failureSodium reabsorptionUrine collectionSpot urine sodium concentrationsIntravenous loop diureticsNeutral sodium balanceAcute heart failureDecompensated heart failureRenal sodium reabsorptionSubgroup of patientsUrine sodium concentrationSpot urine samplesDiuretic therapySodium aviditySodium excretionUrine sodiumCreatinine ratioLoop diureticsDiuretic administrationSodium balanceNatriuresisHealthy volunteers
2020
Safety and Efficacy of an Automated Nurse-Driven Diuretic Titration Protocol: the Yale Diuretic Pathway
Meegan G, Sangkachand P, O'Brien M, Riello R, Soucier R, Jacoby D, Gleason O, Fleming J, Griffin M, Ivey-Miranda J, Cox Z, Rao V, Testani J. Safety and Efficacy of an Automated Nurse-Driven Diuretic Titration Protocol: the Yale Diuretic Pathway. Journal Of Cardiac Failure 2020, 26: s22. DOI: 10.1016/j.cardfail.2020.09.070.Peer-Reviewed Original ResearchAcute decompensated heart failureDiuretic doseLoop diureticsSodium outputBlood pressureEMR orderTitration protocolDecompensated heart failureSystolic blood pressureDaily urine outputSpot urine samplesNet fluid outputDiuretic resistanceFurosemide equivalentsFirst doseMedian doseSodium excretionHeart failureSerum potassiumSubsequent dosesUrine outputClinical outcomesMedian timeSerum magnesiumSame doseValidation of Natriuretic Response Prediction Equation in Patients with Acute Decompensated Heart Failure
Gleason O, Meegan G, Fleming J, Griffin M, Ivey-Miranda J, Cox Z, Rao V, Testani J. Validation of Natriuretic Response Prediction Equation in Patients with Acute Decompensated Heart Failure. Journal Of Cardiac Failure 2020, 26: s2. DOI: 10.1016/j.cardfail.2020.09.015.Peer-Reviewed Original ResearchNatriuretic responseSodium outputUrine collectionDiuretic administrationAcute decompensated heart failureIntravenous loop diuretic therapyLoop diuretic administrationLoop diuretic therapySpot urine sodiumDecompensated heart failureHeart failure admissionsRoutine clinical practiceSpot urine samplesNet fluid outputTotal sodium excretionUrine spot samplesADHF patientsDiuretic therapySodium excretionUrine sodiumHeart failureLoop diureticsUrine outputClinical practiceFluid outputRenal Negative Pressure Treatment as a Novel Therapy for Cardio-Renal Syndrome
Maulion C, Asher J, Moskow J, Ivey-Miranda J, Fleming J, Gleason O, Meegan G, Rao V, Testani J. Renal Negative Pressure Treatment as a Novel Therapy for Cardio-Renal Syndrome. Journal Of Cardiac Failure 2020, 26: s6-s7. DOI: 10.1016/j.cardfail.2020.09.027.Peer-Reviewed Original ResearchUrine outputNegative pressure treatmentCreatinine clearanceLoop diureticsTubular pressureAcute decompensated heart failure hospitalizationHF inductionElevated filling pressuresHigh-dose furosemidePrimary therapeutic objectiveCardio-renal syndromeHeart failure hospitalizationHeart failure modelUrinary collecting systemStable cardiac outputDose furosemideCardiac tamponadeFailure hospitalizationSodium excretionHemodynamic profileRenal functionKidney functionR kidneysSwan-GanzCardiac output
2019
Rapid and Accurate Assessment of Diuretic Response: Validation of an Equation to Predict Diuretic Induced Sodium Output Using a Spot Urine Sample
Griffin M, Struyk G, Fleming J, Shamlian P, Wycallis E, Pattoli M, Thomas A, Stewart B, Barnett J, Gomez N, Ivey-Miranda J, Rao V, Testani J. Rapid and Accurate Assessment of Diuretic Response: Validation of an Equation to Predict Diuretic Induced Sodium Output Using a Spot Urine Sample. Journal Of Cardiac Failure 2019, 25: s52-s53. DOI: 10.1016/j.cardfail.2019.07.148.Peer-Reviewed Original ResearchPoor diuretic responseSpot urine samplesNet fluid balanceDiuretic responseSodium excretionUrine collectionDiuretic administrationSodium outputValidation cohortWeight lossUrine samplesFluid balanceCumulative sodium excretionTypes of diureticsRoutine clinical practiceNet fluid lossAssessment of responseDiuretic doseDiuretic periodDiuretic therapyBladder dysfunctionLoop diureticsSpot urineMedical recordsClinical trialsBiomarkers of Intravascular and Extravascular Volume Overload: Associations with Parameters of Cardio-Renal Dysfunction
Gomez N, Stewart B, Barnett J, Thomas A, Wycallis E, Pattoli M, Struyk G, Fleming J, Shamlian P, Raghavendra P, Mahoney D, Ivey-Miranda J, Griffin M, Rao V, Testani J. Biomarkers of Intravascular and Extravascular Volume Overload: Associations with Parameters of Cardio-Renal Dysfunction. Journal Of Cardiac Failure 2019, 25: s21. DOI: 10.1016/j.cardfail.2019.07.060.Peer-Reviewed Original ResearchIntravascular volume overloadCardio-renal dysfunctionExtravascular volume overloadNT-proBNPCA 125Volume overloadDiuretic efficiencyFluid overloadHeart failureUrinary kidney injury molecule-1Kidney injury molecule-1Higher NT-proBNPLoop diuretic dosePlasma NT-proBNPInjury molecule-1Median NT-proBNPCarbohydrate antigen 125Cardio-renal functionIntravascular fluid overloadExtravascular fluid overloadDiuretic doseIntravascular overloadLower eGFRSodium excretionUrine albuminSafety and Efficacy of an Auto-Titrating Diuretic Protocol: A Pilot
Griffin M, Flemming J, Pattoli M, Stewart B, Gomez N, Barnett J, Thomas A, Wycallis E, Struyk G, Shamlian P, Mahoney D, Ivey-Miranda J, Ivey-Miranda J, Rao V, Testani J. Safety and Efficacy of an Auto-Titrating Diuretic Protocol: A Pilot. Journal Of Cardiac Failure 2019, 25: s52. DOI: 10.1016/j.cardfail.2019.07.147.Peer-Reviewed Original ResearchDiuretic resistanceFurosemide equivalentsRenal functionBlood pressureHeart failureWeight lossHeart failure physiciansNon-randomized pilotTraditional diuretic therapyMajority of patientsSystolic blood pressureRapid dose escalationMaximum daily doseSpot urine samplesDiuretic doseDiuretic protocolDiuretic therapyDiuretic dosesHF patientsSodium excretionStarting doseElectrolyte abnormalitiesHospital daysDaily doseDose escalationUrine Growth Differentiation Factor-15 is Not an Independent Biomarker of Cardio-Renal Interactions in Patients with Heart Failure
Barnett J, Stewart B, Gomez N, Thomas A, Wycallis E, Pattoli M, Struyk G, Fleming J, Shamlian P, Raghavendra P, Mahoney D, Ivey-Miranda J, Griffin M, Rao V, Testani J. Urine Growth Differentiation Factor-15 is Not an Independent Biomarker of Cardio-Renal Interactions in Patients with Heart Failure. Journal Of Cardiac Failure 2019, 25: s21-s22. DOI: 10.1016/j.cardfail.2019.07.063.Peer-Reviewed Original ResearchGrowth differentiation factor 15Plasma GDF-15GDF-15Heart failureDiuretic efficiencyDifferentiation factor 15Independent predictorsFactor 15Urinary cystatin C levelsCardio-renal interactionsLoop diuretic doseWorse kidney functionGlomerular filtration rateCystatin C levelsDiuretic doseNT-proBNPSodium excretionDiabetic patientsFractional excretionKidney functionPrognostic valueIndependent biomarkerOutpatient settingStress-responsive biomarkersFiltration rate