PMID- 10320123
OWN - NLM
STAT- MEDLINE
DCOM- 19990517
LR  - 20190627
IS  - 0002-9343 (Print)
IS  - 0002-9343 (Linking)
VI  - 106
IP  - 1
DP  - 1999 Jan
TI  - Diuretic treatment and diuretic resistance in heart failure.
PG  - 90-6
AB  - Diuretic therapy decreases capillary wedge pressure and improves New York Heart 
      Association (NYHA) functional class both in acute and chronic heart failure. In 
      advanced symptomatic heart failure, loop diuretics are generally necessary to 
      improve symptoms of congestion. Diuretic resistance in the edematous patient has 
      been defined as a clinical state in which diuretic response is diminished or lost 
      before the therapeutic goal of relief from edema has been reached. The major 
      causes of diuretic resistance are functional renal failure (prerenal azotemia), 
      hyponatremia, altered diuretic pharmacokinetics, and sodium retention caused by 
      counterregulatory mechanisms intended to reestablish the effective arterial blood 
      volume. Therapeutic approaches to combat diuretic resistance include restriction 
      of fluid and sodium intake, use of angiotensin-converting-enzyme (ACE) 
      inhibitors, changes in route (oral, intravenous) and timing (single dose, 
      multiple doses, continuous infusion) of diuretic therapy, and use of diuretic 
      combinations.
FAU - Kramer, B K
AU  - Kramer BK
AD  - Klinik und Poliklinik fur Innere Medizin II, University of Regensburg, Germany.
FAU - Schweda, F
AU  - Schweda F
FAU - Riegger, G A
AU  - Riegger GA
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Am J Med
JT  - The American journal of medicine
JID - 0267200
RN  - 0 (Diuretics)
SB  - IM
MH  - Diuretics/administration & dosage/pharmacokinetics/*therapeutic use
MH  - Drug Administration Schedule
MH  - Drug Therapy, Combination
MH  - Heart Failure/complications/*drug therapy/*physiopathology
MH  - Humans
MH  - Hyponatremia/complications
MH  - Kidney Failure, Chronic/complications
RF  - 70
EDAT- 1999/05/13 00:00
MHDA- 1999/05/13 00:01
CRDT- 1999/05/13 00:00
PHST- 1999/05/13 00:00 [pubmed]
PHST- 1999/05/13 00:01 [medline]
PHST- 1999/05/13 00:00 [entrez]
AID - S0002-9343(98)00365-9 [pii]
AID - 10.1016/s0002-9343(98)00365-9 [doi]
PST - ppublish
SO  - Am J Med. 1999 Jan;106(1):90-6. doi: 10.1016/s0002-9343(98)00365-9.