RecruitingNAINTERVENTIONAL

Spot Analysis of Natriuresis to Guide up- or Down-titration of Diuretic Therapy in Ambulatory Patients With Chronic Heart Failure

This study aims to find a better way to adjust water tablet (diuretic) doses for people with heart failure. Heart failure can cause too much fluid in the body, and water tablets help remove this. Currently, doctors often change these doses based on how a patient feels. This research wants to see if quick urine tests that measure salt (sodium) can guide doctors more accurately. Some people in the study will have their water tablet dose increased if they have too much fluid, while others who are stable might have their dose safely lowered. The study also wants to see how practical and helpful this new testing method is in real life.

At a glance

Status

Recruiting

Phase

Sponsor

Cardiology Research UBC

Enrolment target

300

Start

04 Nov 2025

Estimated completion

30 Dec 2027

Heart Failure Diuretics

What is this study about?

Heart failure is a long-term condition where your heart doesn't pump blood as well as it should. This can lead to fluid building up in your body, often causing swelling in your legs and shortness of breath. To help with this, doctors often prescribe medicines called diuretics, or 'water tablets', which help your body get rid of extra salt and water through your urine. Usually, doctors adjust the dose of these tablets based on your symptoms and what they observe during your check-ups.

This study is testing a new approach. It explores if a quick urine test, done right there at the clinic, can measure how much salt is in your urine. This measurement can show how well your water tablets are working to remove fluid. The idea is that this information could give doctors a more objective way to decide if your water tablet dose needs to be increased (if you have too much fluid) or even safely decreased (if you’re very stable and might not need such a high dose).

This is a 'pilot' study, meaning it's a smaller, early stage of research to see if this new method is practical and helpful for patients and doctors. The results will help guide bigger studies in the future. The overall goal is to find better ways to manage fluid build-up in heart failure, potentially leading to fewer hospital stays and improved quality of life.

Key takeaways

This study evaluates a new urine test to guide water tablet doses for heart failure.
It aims to find a more precise way to manage fluid build-up.
Some patients might have their water tablet dose increased; others might have it safely lowered.
The study lasts 90 days and involves urine samples and follow-up visits.
Participation could lead to better-tailored treatment for heart failure.
It's a 'pilot' study, meaning it's an early step to see if this new method is practical.

Who may be eligible?

To be considered for this study, you need to be at least 18 years old and have a confirmed diagnosis of heart failure. You also need to be taking 'loop diuretics', which are a common type of water tablet, and live in the VCH or PHC regions.

There are a few different groups in the study. Some people will be able to join if they currently have symptoms of fluid build-up, and others if they are feeling stable and their fluid levels are well managed. Another group will be observed without any changes to their treatment to help understand heart failure generally.

However, you won't be able to join if your kidneys aren't working well enough (specifically if your eGFR is below 20), if you're on kidney dialysis, or if you're currently so unwell with heart failure that you need to be in hospital. You also need to be able to understand the study and agree to take part, and be able to provide urine samples as requested.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

I am 18 years old or older.
I have been diagnosed with heart failure.
I am currently taking loop diuretics (a type of water tablet).
I live in the specific regions mentioned (VCH or PHC).
I don't have severe kidney problems or need dialysis.
I am able to give urine samples when required.

Answer every question to see your result.

What does participation involve?

If you join this study, your involvement will last for 90 days (about three months). At your initial visit and follow-up appointments, you will provide a urine sample. This sample will be quickly tested in the clinic to measure the salt level in your urine. Based on your health and which study group you are in, your doctor might use these test results to help decide whether to adjust your water tablet dose. For those not in the observation group, your treatment will be closely guided by either these urine test results or the standard way your doctor usually manages your care. You'll also have routine check-ups where doctors will look at your overall health, how you're feeling, and take blood tests.

Potential risks and benefits

Participating in this study might offer you the benefit of having your diuretic treatment more precisely tailored to your body's needs, potentially leading to better control of fluid build-up. For some, it might also offer the chance to safely lower their diuretic dose if appropriate. As with any study, there could be risks, such as side effects from medication adjustments, though these will be carefully monitored by the healthcare team. You are free to withdraw from the study at any time, for any reason, without it affecting your usual medical care.

Locations (1)

Vancouver General Hospital
Verified postcode
Vancouver, Canada· Recruiting

Common questions

What are 'water tablets'?

Water tablets, also called diuretics, are medicines that help your body get rid of extra salt and water, which can build up when you have heart failure.

What is 'natriuresis'?

Natriuresis is a medical term for getting rid of salt (sodium) in your urine. This study looks at measuring how much salt your body is getting rid of.

Will my medication definitely change if I join?

Not necessarily. If you're in one of the active treatment groups, your doctor might adjust your dose based on the urine test results or standard care, but it won't change if you're in the observation group.

How long will I be in the study?

Your involvement in this pilot study will last for 90 days, which is about three months.

Is this new urine test painful?

No, the urine test is not painful. You will simply provide a urine sample, similar to other routine medical tests.

How to find out more

Natalie Bloch, MD

natalie.blochisenberg@vch.ca 604-875-4111 Official trial record

Always speak to your GP or specialist before deciding to take part in a study.