NCT07631780Not yet recruiting
SURE-HF: Urinary Sodium-Guided Diuretic Therapy in Heart Failure
Urinary Sodium-Guided Optimization of Diuretic Therapy in Patients With Worsening Heart Failure: Rationale and Design of a Pragmatic Randomized Controlled Trial (SURE-HF Trial)
Source: ClinicalTrials.gov · Last updated 8 Jun 2026
Brief summary (registry, in English)
The SURE-HF trial is a pragmatic, multicentre, randomized controlled study evaluating natriuresis-guided optimization of intravenous loop diuretic therapy in patients hospitalized with worsening heart failure (WHF). The study aims to determine whether serial urinary sodium assessment combined with a structured decongestive treatment algorithm improves decongestion, reduces the need for therapy escalation, and enhances discharge readiness compared with standard care. Participants will be randomized to standard urine output-guided therapy or natriuresis-guided decongestive strategies using different intravenous loop diuretic administration regimens. The study integrates bedside diagnostic tools including lung ultrasound, inferior vena cava assessment, focused echocardiography, and serial clinical congestion monitoring. The primary endpoint is a hierarchical composite outcome including escalation of heart failure therapy, persistent congestion at discharge, inability to transition to oral loop diuretics by Day 5, and residual ultrasound congestion. The findings of the SURE-HF trial may support implementation of urinary sodium-guided and ultrasound-assisted decongestive therapy in routine heart failure management.
- Status (registry)
- Not yet recruiting
- Study type
- Interventional
- Enrollment
- 260 (estimated)
- First submitted
- 27 May 2026
- Start date
- Jun 2026
- Primary completion date
- Dec 2027
- Lead sponsor
- Nurgul Ablakimova
- Diseases
- Heart failure
- NCT number
- NCT07631780
What you commit to
- Study type: Interventional
- Planned participants: 260
- From Jun 2026 to the primary completion date, Dec 2027
- 1 site in 1 country
- Visits and tests: ask the trial team, the registry does not list them
Built from the registry fields of ClinicalTrials.gov. It describes the study, not your situation.
Who cannot take part
Copied verbatim from ClinicalTrials.gov and grouped by topic. Only the trial team decides who can take part.
Prior treatment
- Acute coronary syndrome within the previous 30 days.
Other illness
- Acute heart failure requiring urgent invasive intervention, including cardiogenic shock or mechanical circulatory support.
- Active malignancy.
Lab values
- Estimated glomerular filtration rate (eGFR) \<30 mL/min/1.73 m² or requirement for renal replacement therapy.
- Hypokalemia (\<3.5 mmol/L) or hyperkalemia (≥5.5 mmol/L).
- Clinically significant hyponatremia (\<130 mmol/L) or hypernatremia (\>150 mmol/L).
- Significant comorbidities affecting sodium-water balance (e.g., liver cirrhosis with ascites, nephrotic syndrome, severe infection or sepsis).
Other
- Current admission to an intensive care unit.
- Systolic blood pressure ≤90 mmHg or requirement for inotropic/vasopressor support.
- Recent use (≤48 hours) of inotropic agents affecting fluid and electrolyte balance.
- Pregnancy or breastfeeding.
- Inability to comply with the study protocol or participation in another interventional clinical trial.
Who the study is looking for
- Age ≥18 years.
- Confirmed diagnosis of worsening heart failure (WHF), characterized by symptoms and signs of acute decompensation requiring hospitalization for intensification of intravenous diuretic therapy.
- Previous intake of a loop diuretic (torasemide or furosemide) in any dose for at least 2 days before hospitalization.
- Presence of clinical signs and symptoms of congestion (e.g., dyspnea, orthopnea, peripheral edema, pulmonary congestion).
- Provision of written informed consent.
Age in the registry: 18 years to - · Sex: All · Does not accept healthy volunteers
Sites (1)
Sites in registry order. Pick your city on the disease page to sort them by distance.
| Site | City | Country | Site status |
|---|---|---|---|
| West Kazakhstan Marat Ospanov Medical University Coordinator of this site? Confirm its status | Aktobe | Kazakhstan | Unknown status |
This page is information, not medical advice. Discuss any trial with your doctor.