Diuretic Treatment in Heart Failure

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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...

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heart failure (hf) is still a major problem worldwide with high morbidity and mortality rates. the recently developed medication for hf is still incapable of reducing its morbidity and mortality, and clinical data supporting the efficacy and safety of its mainstay therapy remain insufficient. arginine-vasopressin (avp) plays important roles in circulatory and water homeostasis, one of which is ...

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Diuretic usage in heart failure: a continuing conundrum in 2005.

Several large well-designed clinical trials have shown that the use of diuretics is beneficial in patients with hypertension. However, similarly robust data regarding their role in chronic heart failure are lacking. Historically, diuretics were developed for treatment of sodium and water retention in oedematous disorders and clinically, they remain the most potent drugs available to relieve sym...

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Combined aquaretic and diuretic therapy in acute heart failure

INTRODUCTION Acute heart failure (AHF) is a leading cause of hospitalization and readmission in the US. The present study evaluated maximum diuresis while minimizing electrolyte imbalances, hemodynamic instability, and kidney dysfunction, to achieve a euvolemic state safely in a shorter period of time. METHODS AND RESULTS A protocol of combined therapy with furosemide, metolazone, and spirono...

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Diuretic drugs are used almost universally in patients with congestive heart failure, most frequently the potent loop diuretics. Despite their unproven effect on survival, their indisputable efficacy in relieving congestive symptoms makes them first line therapy for most patients. In the treatment of more advanced stages of heart failure diuretics may fail to control salt and water retention de...

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ژورنال

عنوان ژورنال: New England Journal of Medicine

سال: 2017

ISSN: 0028-4793,1533-4406

DOI: 10.1056/nejmra1703100