title: Effects of limiting fluid intake on clinical and laboratory outcomes in patients with heart failure. Results of a meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  The guidelines of the Scientific Societies of Cardiology recommend limiting fluid intake as a nonpharmacological measure for the management of chronic heart failure (HF). However, many patients with HF may suffer from severe thirst. A meta-analysis was performed to evaluate the effect of limiting fluid consumption based on various clinical and laboratory outcomes in patients with chronic HF.
  
  
  METHODS
  Only randomized controlled trials comparing liberal and restricted fluid oral intake in patients with HF were included. Primary outcomes were HF hospitalizations and all-cause mortality. Secondary outcomes were the sensation of thirst, the duration of therapy with intravenous diuretics, and the serum levels of creatinine, sodium, and B-type natriuretic peptide (BNP).
  
  
  RESULTS
  Six studies met the inclusion criteria. Significant heterogeneity was detected for the majority of outcomes. In 5 studies, patients with restricted fluid intake compared to patients with free consumption of beverages had similar rehospitalization and mortality rates. There were no differences regarding patients' sense of thirst (4 studies), duration of intravenous diuretic treatment (2 studies), serum creatinine levels (5 studies), and serum sodium levels (5 studies). Serum BNP levels were significantly higher in the group with free fluid intake (4 studies).
  
  
  CONCLUSIONS
  In patients with HF, liberal fluid consumption does not seem to exert an unfavorable impact on HF rehospitalizations or all-cause mortality. Further randomized controlled trials are warranted to definitively confirm the present findings.
authors: Cardiology Unit, Presidio Sanitario Intermedio "Elena d'Aosta", via P.Gaurico 21, 80125, Napoli, Italy. devecchis.erre@virgilio.it.
authors: R
authors: R
authors: De Vecchis
authors: Heart Department, Interventional Cardiology, A.O.U. "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy.
authors: C
authors: C
authors: Baldi
authors: Cardiology Unit, Presidio Sanitario Intermedio "Elena d'Aosta", via P.Gaurico 21, 80125, Napoli, Italy.
authors: C
authors: C
authors: Cioppa
authors: Cardiology Unit, Presidio Sanitario Intermedio "Elena d'Aosta", via P.Gaurico 21, 80125, Napoli, Italy.
authors: A
authors: A
authors: Giasi
authors: Cardiology Unit, Presidio Sanitario Intermedio "Elena d'Aosta", via P.Gaurico 21, 80125, Napoli, Italy.
authors: A
authors: A
authors: Fusco
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019411:Clinical Laboratory Techniques / Q000706:statistics & numerical data; D004232:Diuretics / Q000627:therapeutic use*; D005260:Female; D005440:Fluid Therapy / Q000706:statistics & numerical data; D006333:Heart Failure / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D015996:Survival Rate; D013894:Thirst; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D004232:Diuretics
keywords: Cardiovascular outcomes; Dehydration; Heart failure; Thirst; Water intake