Aggressive Fluid, Sodium Restriction in Acute Decompensated Heart Failure – Is it Necessary? eInterview with Luis Beck-da-Silva, MD, ScD
Cardiology Division, Heart Failure Clinic
Hospital de Clínicas de Porto Alegre
Rua Ramiro Barcelos, 2350 Sala 2060
Porto Alegre, RS 90035-903, Brazil  What are the main findings of the study?

Answer: The actual take home message is that fluid and sodium restriction may not be of any benefit in patients hospitalized for acute decompensated heart failure. This time-honoured medical advice may have become outdated since the medical therapy has evolved significantly in the last 20 years. It always seemed reasonable to restrict water and sodium, however, it may have no effect in face of many othar therapies. At least, by restricting water, our patients suffer from thirst and this adds significantly to an already jeopardized quality of life in this patients.  Were any of the findings unexpected?

Answer: The results were somewhat expected for those who work on the field as it follows the trend of previous findings. For the majority of clinicians, it is unexpected. It is not what is recommended in all heart failure guidelines.  What should clinicians and patients take away from this study?

Answer: At least for heart failure inpatients, not to prescribe salt and water restriction.  What recommendations do you have for future research as a result of your study?

Answer: These findings could be expanded toward larger, multicentric trials. The same question should also be better examined in ambulatory HF patients. Up to now, I would rather stick to the trial results and apply it only for acute decompensated heart failure.


Aliti G, Rabelo ER, Clausell N, Rohde LE, Biolo A, Beck-da-Silva L. Aggressive Fluid and Sodium Restriction in Acute Decompensated Heart Failure: A Randomized Clinical Trial. JAMA Intern Med. 2013;():1-7. doi:10.1001/jamainternmed.2013.552.

Last Updated on September 19, 2013 by Marie Benz MD FAAD