Hüser, Christoph 
ORCID: 0000-0002-6112-4678, Hartnack, Lena, Hackl, Matthias Johannes ORCID: 0000-0002-4199-3374, Cukoski, Sadrija ORCID: 0000-0002-6427-177X, Macherey-Meyer, Sascha ORCID: 0000-0002-7080-6611, Adler, Christoph, Möllenhoff, Kathrin ORCID: 0000-0001-7861-3892, Suárez, Victor ORCID: 0000-0003-4781-6480 and Burst, Volker ORCID: 0000-0002-0256-6628
(2025).
Pilot Study Identifying Predictive Factors of Diuretic Effectiveness in Emergency Department Patients with Fluid Overload.
The Journal of Emergency Medicine, 76.
pp. 9-16.
Elsevier.
ISSN 0736-4679
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Abstract
Abstract—Background: Effective diuretic therapy in emergency department (ED) patients with fluid overload is challenging. Objectives: The objective of this study was to evaluate clinical and laboratory parameters for predict- ing an adequate response to initial diuretic therapy in ED patients with edema. Methods: In this prospective, obser- vational study, patients presenting to the ED of a tertiary hospital with edema of cardiac or renal cause were in- cluded. Intravenous furosemide was administered according to a prespecified protocol and urine output was recorded. Group comparison and univariable logistic regression anal- yses were performed to explore the predictive impact of various clinical and laboratory factors on diuretic success defined as urine volume ≥ 600 mL in the first 6 h vs. failure (< 600 mL in the first 6 h)—focusing on urinary sodium and conductivity as a simple and inexpensive test. Results: A total of 101 patients were analyzed. The me- dian 6-h urine output was 1100 mL (interquartile range 600, 1700). A higher systolic blood pressure, estimated glomeru- lar filtration rate, urine sodium, and urine electrical con- ductivity were each associated with achieving at least 600 mL urine output in 6 h. In univariable analysis, a urine sodium threshold of > 72.5 mmol/L and a urine conduc- tivity > 12.0 mS/cm showed a positive predictive value of 93% and 89%, for sufficient diuresis. Conclusions: Urine sodium and urine electrical conductivity were associated with diuretic success in this pilot study. As these parame- ters can be determined prior to treatment initiation, their value as predictive markers should be evaluated in further studies.
| Item Type: | Article |
| Creators: | Creators Email ORCID ORCID Put Code Hartnack, Lena UNSPECIFIED UNSPECIFIED UNSPECIFIED Adler, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED |
| URN: | urn:nbn:de:hbz:38-806182 |
| Identification Number: | 10.1016/j.jemermed.2025.07.013 |
| Journal or Publication Title: | The Journal of Emergency Medicine |
| Volume: | 76 |
| Page Range: | pp. 9-16 |
| Number of Pages: | 8 |
| Date: | September 2025 |
| Publisher: | Elsevier |
| ISSN: | 0736-4679 |
| Language: | English |
| Faculty: | Faculty of Medicine |
| Divisions: | Faculty of Medicine > Innere Medizin > Klinik II für Innere Medizin - Nephrologie, Rheumatologie, Diabetologie und Allgemeine Innere Medizin Faculty of Medicine > Innere Medizin > Klinik III für Innere Medizin - Kardiologie, Pneumologie, Angiologie und internistische Intensivmedizin Faculty of Medicine > Medizinische Statistik und Bioinformatik > Institut für Medizinische Statistik und Bioinformatik � IMSB |
| Subjects: | Medical sciences Medicine |
| Uncontrolled Keywords: | Keywords Language luid overload ; volume overload ; edema ; heart failure ; diuretic resistance ; loop diuretics English |
| ['eprint_fieldname_oa_funders' not defined]: | Publikationsfonds UzK |
| Refereed: | Yes |
| URI: | http://kups.ub.uni-koeln.de/id/eprint/80618 |
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