Pharmacologic and interventional paradigms of diuretic resistance in congestive heart failure: a narrative review.
Journal Article (Journal Article;Review)
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).
Full Text
Duke Authors
Cited Authors
- Acar, S; Sanli, S; Oztosun, C; Afsar, B; Sag, AA; Kuwabara, M; Covic, A; Ortiz, A; Kanbay, M
Published Date
- September 2021
Published In
Volume / Issue
- 53 / 9
Start / End Page
- 1839 - 1849
PubMed ID
- 33392884
Electronic International Standard Serial Number (EISSN)
- 1573-2584
Digital Object Identifier (DOI)
- 10.1007/s11255-020-02704-7
Language
- eng
Conference Location
- Netherlands