SynthesisESC heart failure2026
Fluid restriction vs liberal intake in patients with heart failure: a meta-analysis of randomized trials.
Synthesis in ESC heart failure, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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.
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionIn the absence of enough supportive evidence, the US and European guidelines for the diagnosis and treatment of acute and chronic HF provide only general recommendations supporting fluid restriction (FR) for selected patients with symptomatic HF. We aimed to evaluate the risk of all-cause mortality, hospital readmissions and change in BNP, sodium and perceived thirst in HF patients with FR vs liberal fluid intake.
methodsWe performed a systematic literature search on PubMed, Embase, and Clinicaltrials.gov for relevant randomized controlled trials (RCTs) from inception until June, 2025. Risk ratios (RR), weighted mean differences (WMD) and 95% confidence intervals (CI) were pooled using a random-effects model with the Hartung-Knapp-Sidik-Jonkman (HKSJ) adjustment, and between-study variance (τ²) was estimated with restricted maximum likelihood (REML).
resultsA total of 9 RCTs with 1271 patients (614 in the FR group and 657 in the non-FR group; mean follow-up: 196.33 days) were included in the study. The mean age of patients among FR and non-FR groups was 69.48 and 68.67 years. Pooled analysis showed a statistically significant reduction in the risk of all-cause mortality with restricted fluid intake compared with liberal intake (RR = 0.54; 95% CI: 0.31-0.94; P = 0.03). There were no significant difference between restricted and liberal fluid intake groups (RR = 0.67; 95% CI: 0.28 to 1.65; P = 0.31) regarding heart failure hospital readmissions. No significant differences were observed in perceived thirst (WMD = -6.89; 95% CI: -22.86 to 9.08; P = 0.26), serum BNP levels (WMD = 54.09 pg/mL; 95% CI: -316.86 to 425.04; P = 0.71), or sodium levels (WMD = 1.42 mmol/L; 95% CI: -0.68 to 3.51; P = 0.15).
conclusionFluid restriction reduces the risk of all-cause mortality but not HF rehospitalizations in HF patients. Further studies are warranted to definitively confirm the present findings and result on the suitable changes in recommendations and clinical practice.
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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.