Low Urinary chlorine at hospitalisation Predicts Poor Outcomes in Acute Heart Failure: Study

Published On 2026-01-16 16:30 GMT | Update On 2026-01-16 16:31 GMT

Among hospitalized patients with acute heart failure (AHF), low Urinary chlorine was associated with diuretic resistance, persistent congestion, greater need for aggressive decongestion strategies, worse in-hospital outcomes, and a higher rate of acute heart failure rehospitalisations at 6 months.

The natriuresis measurement is useful to diagnose diuretic resistance (DR) and adjust furosemide doses in acute heart failure (AHF) hospitalized patients, but the utility of urinary chloride is unknown. A study was done to correlate the urine chloride at admission (UCLA) in acute heart failure patients with the development of diuretic resistance and cardiovascular (CV) events at the 180-day outpatient follow-up. A prospective study included patients hospitalized for AHF, without shock, creatinine >2.5 mg/dL or mechanical respiratory support at admission. They received 40 mg of intravenous furosemide at admission, UCLA was measured, and diuretic treatment was based on a protocol. Diuretic resistance was defined as the requirement for furosemide ≥240 mg/day, sequential nephron diuretic blockade (SNB), hypertonic saline serum, or renal replacement therapy.

Results: 116 patients were included, 51% were men, UCLA was 105 meq/L, and diuretic resistance was developed in 17% of patients. The UCLA was associated with the development of DR (p 0.0001; AUC ROC curve 0.81; cut-off point 96 meq/L). UCLA <96 meq/L was associated with persistent congestion (p 0.01), furosemide ≥240 mg/day use (p 0.004), worsening of acute heart failure (p 0.002) and renal function (p 0.02), use of SNB (p 0.001) and inotropic drugs (p 0.007), a longer hospital stay (p 0.02) and a higher CV death (p 0.05). At 180-day follow-up, UCLA <96 meq/L was associated with acute heart failure readmissions (p 0.002).

In acute heart failure hospitalised patients, low UCLA was associated with diuretic resistance , persistent congestion, need for more aggressive decongestion strategies, worse in-hospital clinical outcomes and more acute heart failure hospitalisations at 6 months.

Reference:

Cristhian E. Scatularo, Gardenia Chango Acurio, Luciano Battioni, Analía Guazzone, Hugo O. Grancelli. Urinary chlorine at hospital admission as a predictor of diuretic resistance and clinical evolution in acute heart failure, Current Problems in Cardiology, 2026, 103262, ISSN 0146-2806, https://doi.org/10.1016/j.cpcardiol.2026.103262.

https://www.sciencedirect.com/science/article/pii/S0146280626000058

Keywords:

Low, UCLA, hospitalisation, Predicts, Poor, Outcomes, Acute Heart Failure, Study, Cristhian E. Scatularo, Gardenia Chango Acurio, Luciano Battioni, Analía Guazzone, Hugo O. Grancelli

Article Source : Current Problems in Cardiology

Disclaimer: This website is primarily for healthcare professionals. The content here does not replace medical advice and should not be used as medical, diagnostic, endorsement, treatment, or prescription advice. Medical science evolves rapidly, and we strive to keep our information current. If you find any discrepancies, please contact us at corrections@medicaldialogues.in. Read our Correction Policy here. Nothing here should be used as a substitute for medical advice, diagnosis, or treatment. We do not endorse any healthcare advice that contradicts a physician's guidance. Use of this site is subject to our Terms of Use, Privacy Policy, and Advertisement Policy. For more details, read our Full Disclaimer here.

NOTE: Join us in combating medical misinformation. If you encounter a questionable health, medical, or medical education claim, email us at factcheck@medicaldialogues.in for evaluation.

Dr. Shravani Dali

Dr. Shravani Dali has completed her BDS from Pravara institute of medical sciences, loni. Following which she extensively worked in the healthcare sector for 2+ years. She has been actively involved in writing blogs in field of health and wellness. Currently she is pursuing her Masters of public health-health administration from Tata institute of social sciences. She can be contacted at editorial@medicaldialogues.in.

Comments Policy

Our comments section is governed by our Comments Policy . By posting comments at Medical Dialogues you automatically agree with our Comments Policy , Terms And Conditions and Privacy Policy .

Low Urinary chlorine at hospitalisation Predicts Poor Outcomes in Acute Heart Failure: Study

Similar News

Study Finds 47 Percent of Diabetics Show Heart Calcification Progression Despite Normal BP

Fragmented Circadian Rhythms Linked to Higher Dementia Risk: Study

Cardiovascular Risk Score Predicts Future Serious Eye Disease Risk: Study

Rosuvastatin Shows Cardiovascular Edge but Higher Albuminuria Risk in Diabetic CKD: Study Shows

Low Vitamin D Linked to Higher Death and Heart Risk in Lupus Patients: Study

Elevated lipoprotein(a) levels associated with risk of cardiovascular disease among healthy women: JAMA

Higher maternal blood pressure increases the risk of pregnancy complications, study concludes