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Diuretic therapy for heart failure:focus on resistance to diuretics

Authors: Bektur Sh. Berdibekov

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery of Ministry of Health of the Russian Federation, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation

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Type:  Reviews


DOI: https://doi.org/10.24022/1997-3187-2018-12-4-366-382

For citation: Berdibekov B.Sh. Diuretic therapy for heart failure: focus on resistance to diuretics. Creative Cardiology. 2018; 12 (4): 366–82 (in Russ.). DOI: 10.24022/1997-3187-2018-12-4-366-382

Received / Accepted:  19.10.2018/07.11.2018

Keywords: heart failure diuretics resistance to diuretic therapy causes and mechanisms coping strategies

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Abstract

Most patients with acute decompensation of heart failure have certain symptoms and/or signs of fluid accumulation in the body. One of the main methods of treatment in this case is diuretic therapy. However, some patients may have varying degrees of resistance to diuretic therapy. There are many reasons for resistance to diuretics, it is the determination of the cause of diuretic resistance that can help the clinician in choosing an appropriate strategy for restoring the diuretic response. Although this condition is often found in clinical practice, there is no consensus definition, and recommendations for an optimal therapeutic approach remain limited. In this review, we discuss the current pharmacological principles of diuretic therapy, the causes and mechanisms of resistance to diuretics, and various approaches to overcome resistance to diuretics based on the latest clinical studies.

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About Authors

Bektur Sh. Berdibekov, Postgraduate, orcid.org/0000-0001-7717-4971

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


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