# Diureticastaken bij stabiel mild HF zonder vochtretentie

*geplaatst 2019-11-21 · Hartfalen · European heart journal · doi 10.1093/eurheartj/ehz554 · https://hartvaat.nl/2019/11/21/diureticastaken-bij-stabiel-mild-hf-zonder-vochtretentie/*

Studie die het kortdurend staken van diuretica onderzocht bij stabiele poliklinische hartfalenpatiënten met milde symptomen en optimale therapie.

## English: Short-term diuretic withdrawal in stable outpatients with mild heart failure and no fluid retention receiving optimal therapy: a double-blind, multicentre, randomized trial.

This study tested short-term diuretic withdrawal in stable outpatients with mild heart failure receiving optimal medical therapy, showing that many patients can safely reduce or stop loop diuretics when well-compensated.

## Abstract (original, from the publication)

AIMS: Although loop diuretics are widely used to treat heart failure (HF), there is scarce contemporary data to guide diuretic adjustments in the outpatient setting. METHODS AND RESULTS: In a prospective, randomized and double-blind protocol, we tested the safety and tolerability of withdrawing low-dose furosemide in stable HF outpatients at 11 HF clinics in Brazil. The trial had two blindly adjudicated co-primary outcomes: (i) symptoms assessment quantified as the area under the curve (AUC) of a dyspnoea score on a visual-analogue scale evaluated at 4 time-points (baseline, Day 15, Day 45, and Day 90) and (ii) the proportion of patients maintained without diuretic reuse during follow-up. We enrolled 188 patients (25% females; 59 ± 13 years old; left ventricular ejection fraction = 32 ± 8%) that were randomized to furosemide withdrawal (n = 95) or maintenance (n = 93). For the first co-primary endpoint, no significant difference in patients' assessment of dyspnoea was observed in the comparison of furosemide withdrawal with continuous administration [median AUC 1875 (interquartile range, IQR 383-3360) and 1541 (IQR 474-3124), respectively; P = 0.94]. For the second co-primary endpoint, 70 patients (75.3%) in the withdrawal group and 77 patients (83.7%) in the maintenance group were free of furosemide reuse during follow-up (odds ratio for additional furosemide use with withdrawal 1.69, 95% confidence interval 0.82-3.49; P = 0.16). Heart failure-related events (hospitalizations, emergency room visits, and deaths) were infrequent and similar between groups (P = 1.0). CONCLUSIONS: Diuretic withdrawal did not result in neither increased self-perception of dyspnoea nor increased need of furosemide reuse. Diuretic discontinuation may deserve consideration in stable outpatients with no signs of fluid retention receiving optimal medical therapy. CLINICALTRIALS.GOV IDENTIFIER: NCT02689180.

Auteurs: Luis E Rohde, Marciane M Rover, Jose A Figueiredo Neto, Luiz C Danzmann, Eduardo G Bertoldi, Marcus V Simões, Odilson M Silvestre, Antonio L P Ribeiro, Lidia Zytynski Moura, Luis Beck-da-Silva, Debora Prado, Roberto T Sant'Anna, Leonardo H Bridi, André Zimerman, Priscila Raupp da Rosa, Andréia Biolo

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Bron: European heart journal, https://doi.org/10.1093/eurheartj/ehz554. Bijgewerkt 2026-07-03T18:38:45Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.