Heart FailurePhase 3SALT-HFNCT07596329
Outpatient Hypertonic Saline and Loop Diuretic Combination Therapy in Cardiorenal
A Phase 3 study testing Hypertonic sodium chloride 10%, Sodium Chloride 0.9% and Furosemide intravenous solution in people with Heart Failure and Renal Disease, Chronic, run by University of Monastir.
Trial summary
Congestive heart failure (CHF) remains a major cause of morbidity, rehospitalization, and mortality worldwide, particularly among elderly and polymorbid patients. Systemic congestion is its most characteristic clinical manifestation and the leading cause of hospitalization for acute heart failure. Read more about this study
- Who is it for?
- Ages 18 to 90 years
- Conditions the study is for
- Heart Failure, Renal Disease, Chronic
- What is being tested?
- Hypertonic sodium chloride 10%, Sodium Chloride 0.9% and Furosemide intravenous solution
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 60 participants
- Where
- No sites listed yet
- Study dates
- 1 Sep 2026to 30 Dec 2027
- Phase
- Phase 3
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 90 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Age ≥ 18 years
- Chronic renal insufficiency (serum creatinine > 150 µg/ml)
- Diagnosis of heart failure (preserved or reduced LVEF)
- Signed informed consent
Who cannot join
- Severe hyponatremia (<130 mmol/L) or hypernatremia (>150 mmol/L),
- History of allergic reaction to HSS or furosemide
- Shock or hemodynamic instability
- Pregnancy or breastfeeding
- Chronic dialysis treatment
- Patient refusal or withdrawal of consent
About this study
Official title: Outpatient Hypertonic Saline and Loop Diuretic Combination Therapy in Cardiorenal Syndrome: The SALT-HF Randomized Double-Blind Trial
Congestive heart failure (CHF) remains a major cause of morbidity, rehospitalization, and mortality worldwide, particularly among elderly and polymorbid patients. Systemic congestion is its most characteristic clinical manifestation and the leading cause of hospitalization for acute heart failure. Standard treatment relies on loop diuretics, primarily furosemide, to reduce fluid overload and alleviate congestive symptoms. However, in clinical practice, many patients exhibit an inadequate diuretic response or resistance to furosemide, particularly in the context of cardiorenal syndrome (CRS), where cardiac and renal dysfunction mutually exacerbate each other. This profile, frequently observed in advanced stages of heart failure, significantly limits the effectiveness of guideline-directed medical therapies (GDMTs), particularly SGLT2 inhibitors, mineralocorticoid receptor antagonists, and angiotensin-converting enzyme (ACE) inhibitors, whose use is often restricted by hypotension, hyperkalemia, or impaired renal function.
Thus, in this subgroup of patients, conventional pharmacological approaches encounter a therapeutic barrier, necessitating the search for alternative or complementary strategies targeting sodium and water depletion without compromising renal perfusion. In this context, the combined administration of hypertonic saline (HS) and furosemide has been proposed as a pathophysiologically sound approach to break the vicious cycle of cardiorenal syndrome. Hypertonic saline solution (HSS) acts by restoring effective intravascular volume, improving renal perfusion, and promoting more efficient natriuresis through better furosemide delivery to the distal nephron. Pioneering studies by Paterna et al. showed that the concomitant administration of HSS (1.4-3% NaCl, 150-250 mL) and intravenous furosemide increased diuresis, improved the hemodynamic profile, and reduced the length of hospital stay and readmission rates without deterioration of renal function.
- Conditions
- Heart Failure, Renal Disease, Chronic
- Being tested
- Hypertonic sodium chloride 10%, Sodium Chloride 0.9%, Furosemide intravenous solution
- Medical subject headings
- Heart Failure, Renal Insufficiency, Chronic
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Hypertonic sodium chloride 10%Drug
50 mL of 10% hypertonic sodium chloride (NaCl)
Sodium Chloride 0.9%Drug
50 mL of 0.9% sodium chloride (NaCl)
Furosemide intravenous solutionDrug
Furosemide 250 mg administered intravenously over 60 minutes once weekly for 2 months.
| Study group | Role | What they receive |
|---|---|---|
| HSS group | Experimental | * 50 mL of 10% hypertonic sodium chloride (NaCl) administered intravenously over 60 minutes once weekly for 2 months.
* Furosemide 250 mg administered intravenously over 60 minutes once weekly for 2 months. Receives: Drug: Hypertonic sodium chloride 10%; Drug: Furosemide intravenous solution |
| placebo group | Placebo comparator | * 50 mL of 0.9% sodium chloride (NaCl) administered intravenously over 60 minutes once weekly for 2 months.
* Furosemide 250 mg administered intravenously over 60 minutes once weekly for 2 months. Receives: Drug: Sodium Chloride 0.9%; Drug: Furosemide intravenous solution |
What is being measured
The primary outcome is the main question the study is designed to answer.
Number of participants rehospitalized for heart failure
Description: Number of participants requiring rehospitalization for heart failure during follow-up.
Measured: 30 days and 60 days
All-cause mortality
Description: Number of deaths from any cause during follow-up.
Measured: 30 days and 60 days
Secondary outcomes (4)
Serum creatinine level
Evaluation of serum creatinine levels.
Measured: 30 days 60 days
Blood urea level
Evaluation of blood urea levels.
Measured: 30 days 60 days
BNP or NT-proBNP concentration
Evaluation of BNP or NT-proBNP levels.
Measured: 30days 60 days
Quality of life and patient satisfaction score assessed using a Likert scale
Description: Assessment of quality of life and patient satisfaction using a 5-point Likert scale ranging from 1 to 5, where:
1 = very dissatisfied/very poor quality of life 5 = very satisfied/excellent quality of life
Higher scores indicate better patient satisfaction and quality of life.
Measured: 30 days and 60 days
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted19 May 2026
- Study start1 Sep 2026 (estimated)
- Primary completion30 Nov 2027 (estimated)
- Study completion30 Dec 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Heart FailureStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Participants will be randomized into two parallel groups. The HSS group will receive 50 mL of 10% hypertonic sodium chloride (NaCl) combined with 250 mg of furosemide administered as a slow intravenous infusion over 60 minutes, once weekly for 2 months. The placebo group will receive 50 mL of 0.9% sodium chloride (NaCl) combined with 250 mg of furosemide administered as a slow intravenous infusion over 60 minutes, once weekly for 2 months.
- Masking
- Single blind
- Who is masked
- Care provider
- Enrolment
- 60 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University of Monastir
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Pr. Semir Nouira, University of Monastir
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07596329
- Sponsor's protocol ID
- SALT-HF study
- Acronym
- SALT-HF
- Status last verified
- Jul 2026
- First submitted
- 24 Feb 2026
- Last updated
- 15 Jul 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: PD will not be shared due to concerns related to patient confidentiality and data privacy
Study at a glance
From the registry record, last updated by the sponsor on 15 Jul 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Outpatient Hypertonic Saline and Loop Diuretic Combination Therapy in Cardiorenal Syndrome: The SALT-HF Randomized Double-Blind Trial
- ClinicalTrials.gov ID
- NCT07596329
- Acronym / sponsor ID
- SALT-HF / SALT-HF study
- Conditions
- Heart Failure, Renal Disease, Chronic
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 60 participants (estimated)
- Lead sponsor
- University of MonastirUniversity, hospital or other
- Study start
- 1 Sep 2026 (estimated)
- Primary completion
- 30 Nov 2027 (estimated)
- Study completion
- 30 Dec 2027 (estimated)
- First posted
- 19 May 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Congestive heart failure (CHF) remains a major cause of morbidity, rehospitalization, and mortality worldwide, particularly among elderly and polymorbid patients. Systemic congestion is its most characteristic clinical manifestation and the leading cause of hospitalization for acute heart failure. Standard treatment relies on loop diuretics, primarily furosemide, to reduce fluid overload and alleviate congestive symptoms. However, in clinical practice, many patients exhibit an inadequate diuretic response or resistance to furosemide, particularly in the context of cardiorenal syndrome (CRS), where cardiac and renal dysfunction mutually exacerbate each other. This profile, frequently observed in advanced stages of heart failure, significantly limits the effectiveness of guideline-directed medical therapies (GDMTs), particularly SGLT2 inhibitors, mineralocorticoid receptor antagonists, and angiotensin-converting enzyme (ACE) inhibitors, whose use is often restricted by hypotension, hyperkalemia, or impaired renal function.
Thus, in this subgroup of patients, conventional pharmacological approaches encounter a therapeutic barrier, necessitating the search for alternative or complementary strategies targeting sodium and water depletion without compromising renal perfusion. In this context, the combined administration of hypertonic saline (HS) and furosemide has been proposed as a pathophysiologically sound approach to break the vicious cycle of cardiorenal syndrome. Hypertonic saline solution (HSS) acts by restoring effective intravascular volume, improving renal perfusion, and promoting more efficient natriuresis through better furosemide delivery to the distal nephron. Pioneering studies by Paterna et al. showed that the concomitant administration of HSS (1.4-3% NaCl, 150-250 mL) and intravenous furosemide increased diuresis, improved the hemodynamic profile, and reduced the length of hospital stay and readmission rates without deterioration of renal function.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (care provider)
- Number of arms
- 2
- Model description
- Participants will be randomized into two parallel groups. The HSS group will receive 50 mL of 10% hypertonic sodium chloride (NaCl) combined with 250 mg of furosemide administered as a slow intravenous infusion over 60 minutes, once weekly for 2 months. The placebo group will receive 50 mL of 0.9% sodium chloride (NaCl) combined with 250 mg of furosemide administered as a slow intravenous infusion over 60 minutes, once weekly for 2 months.
| Arm | Type | Receives |
|---|---|---|
| HSS group | Experimental | Drug: Hypertonic sodium chloride 10%, Drug: Furosemide intravenous solution* 50 mL of 10% hypertonic sodium chloride (NaCl) administered intravenously over 60 minutes once weekly for 2 months. * Furosemide 250 mg administered intravenously over 60 minutes once weekly for 2 months. |
| placebo group | Placebo comparator | Drug: Sodium Chloride 0.9%, Drug: Furosemide intravenous solution* 50 mL of 0.9% sodium chloride (NaCl) administered intravenously over 60 minutes once weekly for 2 months. * Furosemide 250 mg administered intravenously over 60 minutes once weekly for 2 months. |
Who may qualify
- Ages
- 18 to 90 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- Age ≥ 18 years
- Chronic renal insufficiency (serum creatinine > 150 µg/ml)
- Diagnosis of heart failure (preserved or reduced LVEF)
- Signed informed consent
Key exclusion criteria (6 listed)
- Severe hyponatremia (<130 mmol/L) or hypernatremia (>150 mmol/L),
- History of allergic reaction to HSS or furosemide
- Shock or hemodynamic instability
- Pregnancy or breastfeeding
- Chronic dialysis treatment
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Hypertonic sodium chloride 10%50 mL of 10% hypertonic sodium chloride (NaCl) | Drug | HSS group |
| Sodium Chloride 0.9%50 mL of 0.9% sodium chloride (NaCl) | Drug | placebo group |
| Furosemide intravenous solutionFurosemide 250 mg administered intravenously over 60 minutes once weekly for 2 months. | Drug | HSS group, placebo group |
Primary outcome
Number of participants rehospitalized for heart failure
Time frame: 30 days and 60 days
Description: Number of participants requiring rehospitalization for heart failure during follow-up.
All-cause mortality
Time frame: 30 days and 60 days
Description: Number of deaths from any cause during follow-up.
4 secondary outcomes
Serum creatinine level
Time frame: 30 days 60 days
Blood urea level
Time frame: 30 days 60 days
BNP or NT-proBNP concentration
Time frame: 30days 60 days
Quality of life and patient satisfaction score assessed using a Likert scale
Time frame: 30 days and 60 days
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 15 Jul 2026.
- Individual participant dataSharing planned: No. PD will not be shared due to concerns related to patient confidentiality and data privacy
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
The record lists no contact. Use the official record to reach the sponsor.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Hypertonic sodium chloride 10%, Sodium Chloride 0.9% and Furosemide intravenous solution in people with Heart Failure and Renal Disease, Chronic, run by University of Monastir.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 15 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Number of participants rehospitalized for heart failure (time frame: 30 days and 60 days). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Jul 2026.