Hodson DZ, et al. - In acute decompensated heart failure (ADHF), researchers intended to clearly characterize sodium excretion as well as to assess the prognostic value of urinary sodium and fluid-based metrics. For this purpose, they examined 316 patients with 24-hour sodium excretion available, enrolled in the ROSE-AHF (Renal Optimization Strategies Evaluation-Acute Heart Failure) trial. Protocol-driven high-dose loop diuretic therapy was administered to the patients. Findings revealed highly variable sodium concentration and excretion in these patients. They found a strong correlation between 6-month mortality and sodium excretion; no such correlation was shown with traditional fluid-based metrics. A worse prognosis was predicted by poor sodium excretion, even in the context of fluid loss.