A perspective on diuretic resistance in chronic congestive heart failure. (October 2017)

• Record Type: Journal Article
• Authors: Shah, Niel; Madanieh, Raef; Alkan, Mehmet; Dogar, Muhammad U.; Kosmas, Constantine E.; Vittorio, Timothy J.
• Is Part Of: Therapeutic advances in cardiovascular disease. Volume 11:Number 10(2017)
• Page Start: 271
• Page End: 278
• Publication Date: 2017-10
• Subjects: cardiorenal syndrome -- diuretics -- diuretic resistance -- heart failure -- renal failure; Cardiovascular system -- Diseases -- Periodicals; Cardiovascular system -- Diseases -- Treatment -- Periodicals; Cardiovascular pharmacology -- Periodicals; Cardiovascular Diseases -- diagnosis -- Periodicals; Cardiovascular Diseases -- therapy -- Periodicals; Cardiovascular Agents -- therapeutic use -- Periodicals; Cardiovascular Diseases -- drug therapy -- Periodicals; Cardiovascular System -- drug effects -- Periodicals; Cardiologie; Hart- en vaatziekten; Appareil cardiovasculaire -- Maladies -- Périodiques; Appareil cardiovasculaire -- Maladies -- Traitement -- Périodiques; Pharmacologie cardiovasculaire -- Périodiques; 616.10605
• DOI: 10.1177/1753944717718717
• Languages: English
• ISSNs: 1753-9447

Abstract

Chronic congestive heart failure (CHF) is a complex disorder characterized by inability of the heart to keep up the demands on it, followed by the progressive pump failure and fluid accumulation. Although the loop diuretics are widely used in heart failure (HF) patients, both pharmacodynamic and pharmacokinetic alterations are thought to be responsible for diuretic resistance in these patients. Strategies to overcome diuretic resistance include sodium intake restriction, changes in diuretic dose and route of administration and sequential nephron diuretic therapy. In this review, we discuss the definition, prevalence, mechanism of development and management strategies of diuretic resistance in HF patients.