What are diuretics BN

Diuretics for heart failure

03/01/2009 | CME training • Certified training | Edition 2/2009

The Nephrologist> Issue 2/2009
Dr. R.R. Wenceslaus


In acute cardiac decompensation, diuretics are indispensable drugs for the treatment of pulmonary and peripheral overhydration. The use of diuretics in arterial hypertension in the form of low-dose thiazides is also established. In acute heart failure, diuretics are recommended for symptomatic treatment of overhydration. A benefit of diuretics with regard to hard endpoints in chronic heart failure has not yet been proven. However, there is evidence that a sufficient neurohumoral blockade of the renin-angiotensin-aldosterone system (RAAS) and the sympathetic nervous system (SNS) can drastically reduce the risk of sodium and fluid restriction, decompensation and mortality. Loop and thiazide diuretics as well as potassium-sparing diuretics are used. Side effects include Electrolyte imbalances, acidosis / alkalosis, insulin resistance and ototoxicity. The use of diuretics in kidney failure has no or even an adverse effect on the recovery of kidney function; non-potassium-sparing diuretics probably even lead to an increase in mortality from malignant arrhythmias. A sequential tubular blockade and / or a temporary ultrafiltration or renal replacement therapy may be useful in the case of renocardial syndromes and resistance to conventional therapy; evidence from controlled studies is still lacking.

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Literature About this article
Diuretics for heart failure
Publication date
The Nephrologist Journal of Nephrology and Hypertensiology
Edition 2/2009
Print ISSN: 1862-040X
Electronic ISSN: 1862-0418
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