CASE REPORT article
Front. Cardiovasc. Med.
Sec. Heart Failure and Transplantation
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1625554
This article is part of the Research TopicA Patient-Centered Approach to the Management of Heart Failure and ComorbiditiesView all 8 articles
Case Report: Daily Water Monitoring Provides an Evidence-Based Guide for Safe and Effective Use of Diuretics -A Longitudinal Study
Provisionally accepted
Susie Cha1*
Douglas W Wilmore2,3- 1Global Research and Development, Biospace, Inc., Cerritos, United States
- 2Department of Surgery, Brigham and Women’s Hospital, Boston, United States
- 3Biospace, Inc., Cerritos, United States
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Heart failure (HF) management commonly relies on diuretics, yet standard fixed-dose regimens fail to adjust for daily fluid fluctuations, often leading to suboptimal management. Current tools lack the real-time precision needed to adjust therapy in response to these fluctuations. Bioelectrical impedance analysis (BIA) is a tool that can potentially provide personalized guidance for adjusting diuretic therapy, but its daily clinical utility remains limited.We present the case of an 85-year-old patient with chronic HF who performed daily BIA measurements to guide diuretics administration over 1,201 days. The patient adjusted diuretic administration in response to rises in body weight and extracellular water to total body water (ECW/TBW) ratio, indicating fluid accumulation beyond his baseline variability.The patient maintained full adherence to daily BIA monitoring. Despite using diuretics on only 9.2% of the days, fluid balance remained stable with no changes in cardiac, renal, or electrolyte parameters. Fluid retention resolved within 24 hours following tailored diuretic intervention. Additionally, daily BIA facilitated differentiation between fluid-driven from non-fluid-driven weight changes, improving informed decision-making. This case demonstrates that a daily BIA-guided, patient-led diuretic regimen was feasible and effective in maintaining fluid stability with minimal diuretic use. This approach may serve as a personalized self-care model for chronic HF management.
Keywords: Heart failure1, Bioelectrical Impedance Analysis (BIA)2, fluid management3, self-care4, Case report5
Received: 09 May 2025; Accepted: 14 Jul 2025.
Copyright: © 2025 Cha and Wilmore. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Susie Cha, Global Research and Development, Biospace, Inc., Cerritos, United States
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.