Renal Mechanisms of Diuretic Resistance in Congestive Heart Failure
Abstract
:1. Introduction
2. Diuretics Acting on the Proximal Tubule (PT)
2.1. Acetazolamide
2.2. SGLT2 Inhibitors (SGLT2i)
3. Diuretics Acting in the Loop of Henle
4. The Distal Nephron Acting Diuretics
5. Diuretics Mainly Acting on the Collecting Duct
5.1. The Potassium-Sparing Diuretics
5.2. Aldosterone Antagonists
6. Diuretic Resistance (DR) in Congestive Heart Failure
7. Pre- Distal/Tubular Mechanisms of Diuretic Resistance
8. Contribution of Proximal versus Distal Tubular Mechanisms of Diuretic Resistance (DR)
9. Distal Tubular Mechanisms in DR
10. Diagnosing Diuretic Resistance
11. Diagnosis of Congestion/Decongestion
12. Role of Diuretics in the Treatments of Diuretic Resistance
13. Co-Administration of Diuretics with Albumin
14. Continuous Infusion of Loop Diuretics
15. Hypertonic Saline Infusion (HSS)
16. Combination Diuretic Therapy
16.1. Thiazides
16.2. Aldosterone Antagonists
16.3. Acetazolamide
16.4. Multi-Nephron Segment Diuretic Therapy (MSDT)
16.4.1. SGLT2 Inhibitors
16.4.2. Aquaretics
16.4.3. Ultrafiltration
17. Discussion
18. Conclusions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Natriuretics | Aquaretics | |||
---|---|---|---|---|
Proximal diuretics | Loop diuretics | Distal convoluted tubule | Cortical collecting tubule | Collecting duct |
Carbonic anhydrase inhibitors Sodium-glucose cotransporter 2 inhibitors | Na-K-CI (NKCC2) transport inhibitors | Na-CI (NCC) cotransporter inhibitors | Na channel blockers (ENAC inhibitors) Aldosterone antagonists | Vasopressor receptor blockers |
Acetazolamide Empagliflozin Dapagliflozin Canagliflozin Others... | Furosemide Bumetanide Torasemide Ethacrynic acid a | Hydrochlorothiazide Metolazone Chlorthalidone Indapamide b Others | Amiloride Triameterene Spironolactone Eplerenone | Conivaptan Tolvaptan |
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Lameire, N. Renal Mechanisms of Diuretic Resistance in Congestive Heart Failure. Kidney Dial. 2023, 3, 56-72. https://doi.org/10.3390/kidneydial3010005
Lameire N. Renal Mechanisms of Diuretic Resistance in Congestive Heart Failure. Kidney and Dialysis. 2023; 3(1):56-72. https://doi.org/10.3390/kidneydial3010005
Chicago/Turabian StyleLameire, Norbert. 2023. "Renal Mechanisms of Diuretic Resistance in Congestive Heart Failure" Kidney and Dialysis 3, no. 1: 56-72. https://doi.org/10.3390/kidneydial3010005