Pharmacologic and interventional paradigms of diuretic resistance in congestive heart failure: a narrative review
INTERNATIONAL UROLOGY AND NEPHROLOGY, cilt.53, sa.9, ss.1839-1849, 2021 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Derleme
- Cilt numarası: 53 Sayı: 9
- Basım Tarihi: 2021
- Doi Numarası: 10.1007/s11255-020-02704-7
- Dergi Adı: INTERNATIONAL UROLOGY AND NEPHROLOGY
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, EMBASE, Gender Studies Database, MEDLINE
- Sayfa Sayıları: ss.1839-1849
- Anahtar Kelimeler: Acute kidney injury, Diuretic, Heart failure, Hypertonic saline, Hypervolemia
- Süleyman Demirel Üniversitesi Adresli: Evet
Özet
Diuretic volume reduction continues to be the mainstay of congestive heart failure (CHF) management globally. However, diuretic resistance is a critical topic that lacks standardized evidence-based management guidelines accounting for mechanisms of diuretic resistance, renal function, and co-morbidities. Major healthcare utilization consequences result from this. The authors herein reconcile the definition of renal functional decline with emphasis on biomarker-driven assessment. Novel goal-directed treatment approaches are reviewed including hypertonic saline, acetazolamide, sodium-glucose transporter inhibition, sequential nephron blockade and Elabela-APJ axis targeting are reviewed, as well as percutaneous visceral splanchnic sympathectomy (converting a volume-focused to a distribution-focused paradigm).