Fluid Restriction Recommendations in Heart Failure: Dry as a Bone or Quench Your Thirst?

Daily fluid restriction is 1 of the most common recommendations given to patients with heart failure (HF) despite no compelling supporting evidence or formal endorsement in clinical practice guidelines.1,2 Six previous randomized controlled trials (RCTs) have attempted to address this question by using a heterogeneity of methods, target populations and degrees of fluid restriction.3,4 Because of perceived poor data quality and inconsistent results, the American College of Cardiology/American Heart Association/Heart Failure Society of America (ACC/AHA/HFSA) and European Society of Cardiology (ESC) guidelines do not provide definitive recommendations for daily fluid restriction.