Evidence map›Paper›PMID 40859849›Full record

ArticleBritish journal of clinical pharmacology2026

Effectiveness and safety of combining thiazides with loop diuretics vs. loop diuretics monotherapy in patients with acute decompensated heart failure: A retrospective cohort study.

Chia-Chen Hsu, Hsien-Chih Chiu, Ju-Chieh Wung, Yueh-Ching Chou, Yuh-Lih Chang, Chian-Ying Chou, Chin-Chou Huang

Abstract readComparative Study
In one paragraph

Article in British journal of clinical pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Chia-Chen HsuDepartment of Pharmacy, Taipei Veterans General Hospital, Taipei, Taiwan.ORCID https://orcid.org/0000-0001-5218-716X
Hsien-Chih ChiuDepartment of Pharmacy, Taipei Veterans General Hospital, Taipei, Taiwan.
Ju-Chieh WungDepartment of Pharmacy, Taipei Veterans General Hospital, Taipei, Taiwan.
Yueh-Ching ChouDepartment of Pharmacy, Taipei Veterans General Hospital, Taipei, Taiwan.
Yuh-Lih ChangDepartment of Pharmacy, Taipei Veterans General Hospital, Taipei, Taiwan.
Chian-Ying ChouDepartment of Pharmacy, Taipei Veterans General Hospital, Taipei, Taiwan.
Chin-Chou HuangInstitute of Pharmacology, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.ORCID https://orcid.org/0000-0002-4217-8734

Funding

National Science and Technology Council NSTC111-2314-B-A49A-509-MY3Taipei Veterans General Hospital V111B-043Taipei Veterans General Hospital V113C-141Taipei Veterans General Hospital V114C-005Taipei Veterans General Hospital V114C-234
6 · The paper itself

Abstract

aimsThis study investigated factors associated with and outcomes of combined loop diuretics with hydrochlorothiazide (HCTZ) for acute decompensated heart failure (ADHF).

methodsIn this retrospective study, adults hospitalized for ADHF and who received intravenous loop diuretics between January 2016 and March 2023 were enrolled. Patients were categorized into two groups based on HCTZ use. Factors associated with combination therapy and clinical outcomes were examined. Effectiveness outcomes included weight change and percentage weight change, while safety outcomes focused on acute kidney injury (AKI) and worsening renal function at discharge.

resultsAmong 3493 enrolled patients, 329 received combination therapy. Factors associated with combination therapy included use of thiazide diuretics pre-admission (adjusted odds ratio [aOR]: 1.81; 95% confidence interval [CI]: 1.25-2.62), pre-admission dose of oral loop diuretics (aOR: 1.28 per defined daily dose; 95% CI: 1.05-1.56), lower estimated glomerular filtration rate (aOR: 0.98 per unit; 95% CI: 0.98-0.99), higher N-terminal pro-B-type natriuretic peptide levels (aOR: 1.02 per 1000 unit; 95% CI: 1.01-1.02), and lower serum albumin (aOR: 0.53 per unit; 95% CI: 0.41-0.68). Compared to loop diuretics monotherapy, weight reduction was greater in combination therapy (adjusted difference -1.2 kg; 95% CI: -1.5 to -0.9) and percentage of weight loss (adjusted difference -1.8%; 95% CI: -2.3 to -1.3), but higher risk of AKI (aOR: 2.7; 95% CI: 2.1-3.5) and worsening renal function at discharge (aOR: 2.4; 95% CI: 1.9-3.1).

conclusionsCombination therapy enhanced weight reduction in ADHF; however, it might increase the risk of renal dysfunction.

Indexed as

Heart FailureHydrochlorothiazideSodium Potassium Chloride Symporter InhibitorsAcute DiseaseAcute Kidney InjuryAgedAged, 80 and overDrug Therapy, CombinationFemaleGlomerular Filtration RateHumansMaleMiddle AgedRetrospective StudiesTreatment OutcomeHydrochlorothiazideSodium Potassium Chloride Symporter Inhibitorsdiureticseffectivenessheart failurehydrochlorothiazidesafetythiazide diuretics

Identifiers

PMID40859849
PMCPMC12746373

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.