Diuretic resistance and the role of albumin in congestive heart failure.

Q2 Pharmacology, Toxicology and Pharmaceutics Drugs in Context Pub Date : 2023-12-29 eCollection Date: 2023-01-01 DOI:10.7573/dic.2023-6-5
Carol Fernandez Hazim, Gustavo Duarte, Ana P Urena, Swati Jain, Rishabh Mishra, Timothy J Vittorio, Miguel Rodriguez-Guerra
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Abstract

Diuresis with loop diuretics is the mainstay treatment for volume optimization in patients with congestive heart failure, in which perfusion and volume expansion play a crucial role. There are robust guidelines with extensive evidence for the management of heart failure; however, clear guidance is needed for patients who do not respond to standard diuretic treatment. Diuretic resistance (DR) can be defined as an insufficient quantity of natriuresis with proper diuretic therapy. A combination of diuretic regimens is used to overcome DR and, more recently, SGLT2 inhibitors have been shown to improve diuresis. Despite DR being relatively common, it is challenging to treat and there remains a notable lack of substantial data guiding its management. Moreover, DR has been linked with poor prognosis. This review aims to expose the multiple approaches for treatment of patients with DR and the importance of intravascular volume expansion in the response to therapy.

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充血性心力衰竭中的利尿剂抵抗和白蛋白的作用。
使用襻利尿剂进行利尿是充血性心力衰竭患者容量优化的主要治疗方法,其中灌注和容量扩张起着至关重要的作用。心力衰竭的治疗有严格的指南和大量的证据,但对于标准利尿剂治疗无效的患者,还需要明确的指导。利尿剂抵抗(DR)可定义为在接受适当的利尿剂治疗后,患者的利尿量不足。联合使用利尿剂治疗方案可克服 DR,最近,SGLT2 抑制剂被证明可改善利尿效果。尽管 DR 比较常见,但其治疗难度很大,目前仍明显缺乏指导其治疗的实质性数据。此外,DR 还与预后不良有关。本综述旨在揭示治疗 DR 患者的多种方法,以及血管内容量扩张对治疗反应的重要性。
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来源期刊
Drugs in Context
Drugs in Context Medicine-Medicine (all)
CiteScore
5.90
自引率
0.00%
发文量
63
审稿时长
9 weeks
期刊介绍: Covers all phases of original research: laboratory, animal and human/clinical studies, health economics and outcomes research, and postmarketing studies. Original research that shows positive or negative results are welcomed. Invited review articles may cover single-drug reviews, drug class reviews, latest advances in drug therapy, therapeutic-area reviews, place-in-therapy reviews, new pathways and classes of drugs. In addition, systematic reviews and meta-analyses are welcomed and may be published as original research if performed per accepted guidelines. Editorials of key topics and issues in drugs and therapeutics are welcomed. The Editor-in-Chief will also consider manuscripts of interest in areas such as technologies that support diagnosis, assessment and treatment. EQUATOR Network reporting guidelines should be followed for each article type. GPP3 Guidelines should be followed for any industry-sponsored manuscripts. Other Editorial sections may include Editorial, Case Report, Conference Report, Letter-to-the-Editor, Educational Section.
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