Heart Failure

HF: Fluid and Sodium Restriction (2006)

• Intervention
  For the patient with heart failure, is there an optimal level of fluid and/or sodium restriction which will reduce heart failure symptomology and morbidity/mortality in heart failure?

  • Conclusion

    The limited available evidence supports a 2,000-mg-per-day sodium diet and 1.5L per day fluid restriction. Some studies found a benefit in quality of life, NYHA functional class, sleep disturbance, physical activity, edema, BNP and blood pressure. One recent randomized controlled trial study with a small sample size and short duration indicated a tolerance for a sodium range of 1,610mg to 5,750mg per day for the compensated medically-treated heart failure patient. 

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: Fluid and/or Sodium Restriction and Heart Failure
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Alvelos, M, Ferreira, A, Bettencourt P, et al. The effect of dietary sodium restriction on neurohumoral activity and renal dopaminergic response in patients with heart failure. Eur J Heart Failure. 2004; 6: 593-599.
      • Arcand JL, Brazel S, Joliffe C, et al, Education by a dietitian in patients with heart failure results in improved adherence with a sodium-restricted diet:  A randomized trial. Am Heart J. 2005; 150: 716e1-716e5.
      • Damgaard M, Norsk P et al. Hemodynamic and neuroendocrine responses to changes in sodium intake in compensated heart failure, Am J Physiol Regul Integr Comp Physiol. 2006, 290: R1294-R1301.
      • Kuehneman T, Saulsbury D, Splett P, Chapman DB. Demonstrating the impact of nutrition intervention in a heart failure program. J Am Diet Assoc. 2002; 102: 1,790-1,794.
      • Ramirez EC, Martinez LC, et al. Effects of a Nutritional Intervention on Body Compositiion, Clinical Status, and Quality of Life in Patients with Heart Failure. Nutrition, 2004; 20: 890-895.
  • Search Plan and Results: Fluid and Sodium Restriction 2006