The DynaMed EBM Focus 52: Year in Review 2013 included a conclusion of "Low Sodium Diets Increase Mortality and Readmission Rate in Patients with Systolic Heart Failure Taking Daily Diuretics" based on a systematic review reported in DynaMed EBM Focus in January 2013. The systematic review was retracted in March 2013, and the retraction notice replaced the content in DynaMed in March 2013. 

It remains uncertain whether sodium restriction is helpful or harmful in most patients with heart failure, but sodium restriction appears harmful in patients treated with very high doses of furosemide. The original trials are summarized in the Heart failure topic. The diuretic doses used (furosemide dosing ranging from 250 mg/day to 1,000 mg/day) were so much higher than routine clinical practice that we downgraded the conclusion to "level 3 [lacking direct] evidence."

Brian S. Alper, MD, MSPH, FAAFP

Founder of DynaMed
Vice President of EBM Research and Development, Quality & Standards

dynamed.ebscohost.com