Diuretic Resistance in Heart Failure.
Journal
Cardiology in review
ISSN: 1538-4683
Titre abrégé: Cardiol Rev
Pays: United States
ID NLM: 9304686
Informations de publication
Date de publication:
Historique:
pubmed:
14
4
2020
medline:
1
12
2021
entrez:
14
4
2020
Statut:
ppublish
Résumé
Decompensated heart failure accounts for approximately 1 million hospitalizations in the United States annually, and this number is expected to increase significantly in the near future. Diuretics provide the initial management in most patients with fluid overload. However, the development of diuretic resistance remains a significant challenge in the treatment of heart failure. Due to the lack of a standard definition, the prevalence of this phenomenon remains difficult to determine, with some estimates suggesting that 25-30% of patients with heart failure have diuretic resistance. Certain characteristics, including low systolic blood pressures, renal impairment, and atherosclerotic disease, help predict the development of diuretic resistance. The underlying pathophysiology is likely multifactorial, with pharmacokinetic alterations, hormonal dysregulation, and the cardiorenal syndrome having significant roles. The therapeutic approach to this common problem typically involves increases in the diuretic dose and/or frequency, sequential nephron blockade, and mechanical fluid movement removal with ultrafiltration or peritoneal dialysis. Paracentesis is potentially useful in patients with intra-abdominal hypertension.
Identifiants
pubmed: 32282394
pii: 00045415-202103000-00005
doi: 10.1097/CRD.0000000000000310
doi:
Substances chimiques
Diuretics
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
73-81Informations de copyright
Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
Disclosure: The authors have no conflicts of interest to report.
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