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. 2017 Nov;3(2):108-112.
doi: 10.15420/cfr.2017:10:1.

Dilemmas in the Dosing of Heart Failure Drugs: Titrating Diuretics in Chronic Heart Failure

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Dilemmas in the Dosing of Heart Failure Drugs: Titrating Diuretics in Chronic Heart Failure

David Pham et al. Card Fail Rev. 2017 Nov.

Abstract

Despite advances in medical therapy over the past few decades, the incidence of heart failure hospitalisation continues to rise. Diuretics are the most common therapy used to treat heart failure as they relieve congestion. However, there is a lack of guidance on how to best use these medications. Guidelines support the use of diuretics at the lowest clinically effective dose but do not specify a diuretic strategy beyond that. Here we review the diuretics available for treatment, potential mechanisms of diuretic resistance and ways to address this in the ambulatory setting, and review tools that have been developed to help guide diuretic use in the treatment of chronic heart failure.

Keywords: Loop diuretic; bumetanide; diuretic resistance; furosemide; heart failure; torsemide.

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Conflict of interest statement

Disclosure: The authors have no conflicts of interest to declare.

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References

    1. Fang J, Mensah GA, Croft JB, Keenan NL. Heart failure-related hospitalization in the US, 1979 to 2004. J Am Coll Cardiol. 2008;52:428–34. doi: 10.1016/j.jacc.2008.03.061. - DOI - PubMed
    1. Yancy CW, Jessup M, Bozkurt B et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013;62:e147–239. doi: 10.1016/j.jacc.2013.05.019. - DOI - PubMed
    1. Neuberg GW, Miller AB, O’Connor CM et al. Diuretic resistance predicts mortality in patients with advanced heart failure. Am Heart J. 2002;144:31–8. doi: 10.1067/mhj.2002.123144. - DOI - PubMed
    1. Wilcox CS. New insights into diuretic use in patients with chronic renal disease. J Am Soc Nephrol. 2002;13:798–805. - PubMed
    1. Michael Felker G. Diuretic management in heart failure. Congest Heart Fail. 2010. pp. S68–72. - DOI - PubMed