HUMAN ALBUMIN IN HEART FAILURE - DIORASIS TRIAL
Patients hospitalized for acute decompensation of CHF are usually complicated by worsening renal function (WRF) which leads to diuretic resistance and inadequate decongestion as well as poor prognosis. WRF has been attributed to a reflex renal vasoconstriction elicited by intravascular volume depletion during brisk diuresis. The investigators hypothesize that CHF patients with hepatic dysfunction are more prone to WRF due to poor albumin production. This sub-group of CHF patients may benefit more (increased diuretic efficacy and protected against worsening renal function) by the use of IV loop diuretics in combination with an intravascular volume expander such as IV Human Albumin.
• age over 18 yrs
• acute decompensation of CHF
• evidence of hepatic dysfunction by laboratory biochemical measurements or imaging (liver ultrasonography)
• history of CHF with previous use of an oral loop diuretic
• anticipated need for IV diuretic therapy for at least 72 hours
⁃ There is no pre-specified inclusion criterion with respect to ejection fraction