Simple Urine Composition-based Personalized Algorithm for Effective Congestion Relief in Decompensated Heart Failure

NCT ID: NCT07099885

Last Updated: 2025-08-12

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

90 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-08-01

Study Completion Date

2027-01-31

Brief Summary

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The aim of this study is to evaluate the effectiveness of loop diuretic adaptative algorithm that is based on machine learning, urine output prediction tool, in decongestion of acute heart failure patients.

A total of 90 patients will be enrolled in the study. Of these, 45 will be assigned to the algorithm-based intervention group, while the remaining 45 will serve as the control group. In the control group, all decisions regarding diuretic therapy will be made solely by the attending physician, without the use of the algorithm.

Patients will receive intravenous furosemide, with the initial dose determined by the attending physician. Two hours after administration of the diuretic, a spot urine sample will be collected to measure sodium and creatinine concentrations. Based on these values, the 6-hour urine output will be estimated using the machine learning, urine output prediction tool (http://diuresis.umw.edu.pl). This estimate will guide the diuretic therapy plan for the first 24 hours of hospitalization. On the second day, the procedure will be repeated using the same methodology.

Detailed Description

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Conditions

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Acute Heart Failure (AHF) Congestion, Venous

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Algorithm based decongestion

The patient will receive first dose of intravenous loop diuretic determined per the attending physician. Two hours after diuretic administration, a urine sample will be collected to measure sodium and creatinine concentrations. Using these values, the 6-hour urine output will be estimated with the aid of the machine learning, urine output prediction tool. This estimated diuresis will guide the diuretic therapy plan for the first 24 hours using the adaptative furosemide dosing.

On the second day, the procedure will be repeated.

Group Type EXPERIMENTAL

Algorithhm-based decongestion

Intervention Type DIAGNOSTIC_TEST

Patient will receive standarized furosemide dosing based on the result of the algorithm-estimated 6h urine output (profiles of diuretic response).

Standard of care

Group Type ACTIVE_COMPARATOR

Standard of Care (SOC)

Intervention Type DIAGNOSTIC_TEST

Diuretic treatment per attending physician.

Interventions

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Standard of Care (SOC)

Diuretic treatment per attending physician.

Intervention Type DIAGNOSTIC_TEST

Algorithhm-based decongestion

Patient will receive standarized furosemide dosing based on the result of the algorithm-estimated 6h urine output (profiles of diuretic response).

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Adult patients over 18 years of age who provide informed consent
* Ability to enroll in the study within the first 24 hours of hospitalization
* Primary reason for hospitalization is acute heart failure with signs of congestion (at least moderate lower extremity edema)
* NT-proBNP \> 1500 pg/ml
* Anticipated need for diuretic therapy for at least 48 hours from the time of study enrollment

Exclusion Criteria

* End-stage kidney disease requiring renal replacement therapy
* Hemodynamic instability requiring inotropic support
* Active infection requiring intravenous antibiotic therapy
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Wroclaw Medical University

OTHER

Sponsor Role lead

Responsible Party

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Jan Biegus, MD, PhD

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Wroclaw Medical University

Wroclaw, Dolnosląskie, Poland

Site Status RECRUITING

Wroclaw Medical University

Wroclaw, Lower Silesian Voivodeship, Poland

Site Status RECRUITING

Countries

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Poland

Central Contacts

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Jan Biegus, MD, PhD

Role: CONTACT

71 736 42 05 ext. 0048

Gracjan Iwanek, MD

Role: CONTACT

71 733 11 12 ext. 0048

Facility Contacts

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Jan Biegus, M.D., Ph.D.

Role: primary

71 736 42 05 ext. 0048

Gracjan Iwanek, M.D.

Role: backup

71 733 11 12 ext. 0048

Other Identifiers

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226/2025

Identifier Type: -

Identifier Source: org_study_id

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