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NCT Number: NCT06941415

Bumetanide vs. Furosemide in Cirrhosis

Patients with cirrhosis are frequently hospitalized due to an acute decompensation of their liver disease including bleeding, jaundice, encephalopathy, and volume overload. Volume overload is associated with increased mortality from acute hypoxic respiratory failure, hemorrhage from esophageal varices, and spontaneous bacterial peritonitis.

Clinical practice guidelines describe sodium restriction and diuretics as first-line treatment, combined with regular body weight monitoring to assess response. In patients with suboptimal response to furosemide, alternative loop diuretics like torsemide or bumetanide may improve natriuresis. Bumetanide has a theoretic advantage over furosemide due to its more rapid and complete intestinal absorption, combined with a prolonged half-life in patients with hepatic dysfunction. In this pragmatic study, the aim is to compare the efficacy of diuresis with bumetanide versus furosemide among hospitalized patients with cirrhosis.

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Key information

Conditions

Cirrhosis Edema Fibrosis Pathologic Processes Pathological Conditions, Signs and Symptoms Signs and Symptoms

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 3

Primary location

University of Utah Hospital

Salt Lake City, Utah, 84132, United States

Location status: Recruiting

Location contact

Andrea T White, PhD

CONTACT

[email protected]

801-581-7818

Stacy A Johnson, MD

PRINCIPAL_INVESTIGATOR

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • History of liver cirrhosis
  • Clinician placed an order for bumetanide or furosemide in electronic health record within 24 hours of presentation to the hospital

Exclusion criteria

  • Allergy to bumetanide or furosemide
  • Contraindication to diuretic administration (e.g. active bleeding, clinical suspicion of hepatorenal syndrome, hypotension)
  • Incarcerated or in custody of law enforcement
  • Diuretic ordered for purpose other than volume overload (e.g. hyperkalemia, continuation of home medication without clinical signs of volume overload)
  • Inpatient admission not anticipated
  • Not admitted to an inpatient hospital bed following initial evaluation in the emergency department

Treatment and study plan

Bumetanide

Drug

Standard of care treatment with bumetanide (intravenous or oral administration) per treating clinician's orders

Furosemide

Drug

Standard of care treatment with furosemide (intravenous or oral administration) per treating clinician's orders

Primary outcomes

  1. Percent change in weight

    Time frame: 7 days

    Percent change in weight measured in kilograms from date of emergency department presentation (Day 0) to Day 7 of hospitalization, or date of discharge, whichever is earlier

Secondary outcomes

  1. Development of acute kidney injury

    Time frame: 14 days

    Stage 2 or higher acute kidney injury developing within 14 days of presentation to emergency department in accordance with KDIGO criteria

  2. Need for replacement therapy

    Time frame: 14 days

    New initiation of intermittent or continuous hemodialysis within 14 days of presentation to the emergency department

  3. Severe electrolyte derangement

    Time frame: 14 days

    New decrease in serum potassium to less than 2.5 mEq/L within 14 days of presentation to the emergency department

  4. Hospital length of stay

    Time frame: 30 days

    Time from initial presentation to the emergency department to the time of discharge from the hospital or time of death, if a subject dies within the hospital

  5. Unplanned hospital readmission

    Time frame: 30 days

    Readmission to the hospital for an unexpected reason within 30 days of a prior hospital admission

  6. 30-day mortality

    Time frame: 30 days

    Death occurring within the 30 days following presentation to the emergency department and subsequent hospital admission

Study contacts

Contact information is provided by the study sponsor or research team.

Andrea T White, PhD

CONTACT

[email protected]

8015817818

Sponsors and collaborators

Lead sponsor

Stacy Johnson

Other

Registry information

Official study title

Bumetanide vs. Furosemide for Adults Hospitalized With Cirrhosis: the BUFF Trial

Acronym: BUFF

Important dates

Study start
2026
Primary completion
2029
Study completion
2029
First posted
Apr 23, 2025
Registry last updated
Jun 16, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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