What are diuretics BN

Diuretics for heart failure

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

Magazine:
The Nephrologist> Issue 2/2009
Author:
Dr. R.R. Wenceslaus

Summary

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
title
Diuretics for heart failure
Publication date
01.03.2009
DOI
https://doi.org/10.1007/s11560-008-0277-1
magazine
The Nephrologist Journal of Nephrology and Hypertensiology
Edition 2/2009
Print ISSN: 1862-040X
Electronic ISSN: 1862-0418
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