Diuretic dosing in heart failure: more data are needed

Relationship of Loop Diuretic Dosing and Acute Changes in Renal Function during Hospitalization for Heart Failure.

BACKGROUND Worsening renal function (WRF) during heart failure (HF) hospitalization is an accepted correlate of poor prognosis. Loop diuretics are increasingly being considered as a potential cause of worsened HF outcomes, perhaps via WRF. However, the magnitude of worsening in renal function attributable to loop diuretics has not been quantified. METHODS This was a retrospective cohort study...

Obstetric Pharmacokinetic Dosing Studies are Urgently Needed

Use of pharmacotherapy during pregnancy is common and increasing. Physiologic changes during pregnancy may significantly alter the overall systemic drug exposure, necessitating dose changes. A search of PubMed for pharmacokinetic clinical trials showed 494 publications during pregnancy out of 35,921 total pharmacokinetic published studies (1.29%), from the late 1960s through August 31, 2013. Cl...

Ischemic heart disease and women: more answers are needed.

Hypochloremia and Diuretic Resistance in Heart Failure

The fundamental role of sodium in maintenance of fluid homeostasis and progression of heart failure (HF) has been a central paradigm in medicine for more than a century. As a result, a core treatment principal in HF management has been the avoidance of dietary sodium. However, accumulating evidence ranging from the basic sciences to epidemiological studies has challenged this paradigm, suggesti...

Management of heart failure: are specialists really needed?

Heart failure (HF) is regarded as one of the major medical challenges of our time given the increasing prevalence and impaired quality of life, high morbidity, mortality, and socio-economic burden. As a consequence, disease management programmes for patients with HF have been implemented in many countries. The goal of these programmes is to optimize care and to deal with the complexity of the m...