121 - CHFS SPOTLIGHT: BEYOND FUROSEMIDE: RETHINKING DIURETICS IN COMPLEX HEART FAILURE

Thursday, October 23, 2025

11:15am - 12:15pm ET

Room:202

Target Audience: Heart failure specialists, Clinical cardiologists, Trainee (clinical)

Co-Chair(s)

Margot Davis, MD SM FRCPC FCCS (she/her/hers)

Cardiologist
University of British Columbia
University of British Columbia
Justin Ezekowitz, MBBCh, MSc

Cardiologist
UNIVERSITY OF ALBERTA
University of Alberta

Presenter(s)

Kim Connelly, MBBS, PhD, FRCPC, FCCS, FACC, FSCMR (he/him/his)

Professor, Department of Medicine
St Michael's Hospital, University of Toronto
University of Toronto
SP

Stephanie Poon, MD, MSc, FRCPC

Staff Cardiologist
Sunnybrook Health Sciences Centre
University of Toronto
HR

Hongru Ren, MD, FRCPC

Author
Abhinav Sharma, MD, PhD

Assistant Professor
CHFS
Research Institute McGill University Health Centre

Early Career(s)

Aws Almufleh, MBBS, MPH, FASE, FHFSA

Doctor
CHFS and CSE
Queen's University

Trainee(s)

HR

Hongru Ren, MD, FRCPC

Author

Moderator(s)

MK

Morgan Krauter, MN-NP (Adult); DN(C)

Nurse Practitioner Lead, Heart Function Program
Royal Victoria Regional Health Centre

Planning Committee Member(s)

Aws Almufleh, MBBS, MPH, FASE, FHFSA

Doctor
CHFS and CSE
Queen's University
Michael Diamant, MSc, MD, FRCPC (he/him/his)

Clinical Assistant Professor, University of British Columbia
CHFS
University of British Columbia
HR

Hongru Ren, MD, FRCPC

Author

Workshop Description: Managing congestion in heart failure patients with chronic kidney disease (CKD) and diuretic resistance remains a significant clinical challenge. Despite optimal guideline-directed medical therapy and escalating doses of loop diuretics, many patients continue to experience persistent volume overload, leading to recurrent hospitalizations and diminished quality of life. This interactive workshop will explore innovative strategies beyond conventional diuretic approaches, focusing on expanding therapeutic options, optimizing protocols, and implementing outpatient strategies to prevent readmissions.

Through a case-based discussion, attendees will gain insights into novel and emerging interventions that enhance decongestion while mitigating adverse renal and hemodynamic consequences. Our expert panel will present practical approaches that clinicians can integrate into routine practice to improve patient outcomes.

This workshop is designed for cardiologists, nurse practitioners, pharmacists, and other healthcare professionals involved in heart failure management. Join us for an engaging session that will challenge conventional thinking and provide actionable strategies to improve patient care.

Learning Objectives:

At the end of this session participants will be able to:

implement evidence-based urinary sodium-guided diuretic strategies and nurse-driven protocols to optimize decongestion in heart failure patients while minimizing adverse effects;
apply alternative interventions, such as sequential nephron blockade, acetazolamide (IV and PO), hypertonic saline, and tolvaptan, in the management of diuretic resistance; and
consider the implementation of hospital-based decongesting therapies, such as IV diuretics and other advanced interventions, in the outpatient setting to prevent heart failure readmissions by optimizing fluid management and addressing early signs of congestion.