Diuretics in therapy of „diuretic resistance“ by patients with congestive heart failure

Authors: P. Tůma ;  P. Hrdý
Authors‘ workplace: Interní klinika IPVZ Baťovy krajské nemocnice, Zlín, přednosta prim. MUDr. Ivo Oral, CSc.
Published in: Vnitř Lék 2006; 52(9): 782-789
Category: Review


Loop diuretics are integral part of overall therapy of severe congestive heart failure. Approximately 10 - 20 % of patients with congestive heart failure (NYHA class III - IV) do not respond satisfactorily to diuretic treatment. Despite its frequency, the term “diuretic resistance” remains inadequately defined. In general, failure to decrease the extracellular fluid volume despite liberal use of diuretics is often termed “diuretic resistance”. The combination of diuretics, particularly of loop diuretic with thiazide agents, is recommended for prevention as well as treatment of this complication. Effective management is also continuous infusion of loop diuretic. If it is impossible to achieve adequate response by combination of diuretics, increasing of its dosage or/and frequency or continuous infusion, then dialysis methods may be employed (however it is not intended to discuss this option in this article).

Key words:
diuretic resistance - heart failure - loop diuretics - combination of diuretics


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