Diuretics in therapy of „diuretic resistance“ by patients with congestive heart failure

Česká verzia

Authors: P. Tůma; P. Hrdý
Authors place of work: Interní klinika IPVZ Baťovy krajské nemocnice, Zlín, přednosta prim. MUDr. Ivo Oral, CSc.
Published in the journal: Vnitř Lék 2006; 52(9): 782-789
Category: Review

Summary

Loop diuretics are integral part of overall therapy of severe congestive heart failure. Approximately 10 - 20 % of patients with congestive heart failure (NYHA class III - IV) do not respond satisfactorily to diuretic treatment. Despite its frequency, the term “diuretic resistance” remains inadequately defined. In general, failure to decrease the extracellular fluid volume despite liberal use of diuretics is often termed “diuretic resistance”. The combination of diuretics, particularly of loop diuretic with thiazide agents, is recommended for prevention as well as treatment of this complication. Effective management is also continuous infusion of loop diuretic. If it is impossible to achieve adequate response by combination of diuretics, increasing of its dosage or/and frequency or continuous infusion, then dialysis methods may be employed (however it is not intended to discuss this option in this article).

Key words:
diuretic resistance - heart failure - loop diuretics - combination of diuretics

Zdroje

1. Špinar J, Hradec J, Málek I et al. Doporučení pro diagnostiku a léčbu chronického srdečního selhání. Cor Vasa 2001; 43: K123-K137.

2. Aschermann M et al. Kardiologie. Praha: Galén 2004: 2. vol, 908-915.

3. Publication committee for the VMAC Investigators. Intravenous nesiritide vs. Nitroglycerin for treatment of decompensated congestive heart failure: A randomized controlled trial. JAMA 2002; 287: 1531-1540.

4. Rouleau JL, Pfeffer MA, Sestier F et al. Comparison of vasopeptide inhibitor, omapatrilat, and lisinopril on exercise tolerance and morbidity in patients with heart failure: IMPRESS randomised trial. Lancet 2000; 356: 615-620.

5. Follath F, Cleland J, Just H et al. Efficacy and safety of intravenous levosimendan compared with dobutamine in severe low output heart failure (The LIDOStudy): A randomised double-blind trial. Lancet 2002; 360: 196-202.

6. Everest (efficacy of Vasopressin Antagonism in HEart FailurRE: Outcome Study with Tolvaptan). Probíhající studie.

7. Swedberg K, Cleland J, Dargie H et al. Guidelines for the diagnosis and treatment of Chronic Heart failure (update 2005): The Task Force for the diagnosis and treatment of CHF of the European Society of Cardiology. Eur Heart J 2005; 26: 1115-1140.

8. Hunt SA et al. ACC/AHA Guidelines Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committeee to Update the 2001 Gudelines for the Evaluation and Management of Heart Failure). J Am Coll Cardiol 2005; 46: 1-82.

9. Ellison DH. Diuretic therapy and Resistance in congestive heart failure. Cardiology 2001; 96: 132-143.

10. Knauf H, Mutschler E. Sequential Nephron Blockade Breaks Resistance to Diuretics in Edematous States. J Cardiovasc Pharmacol 1997; 26: 367-372.

11. Ravnan SL, Ravnan MC, Sica DA. Diuretic Resistence and Strategie to Overcome Resistence. Congest Heart Fail 2002; 8: 80-85.

12. Sackler-Berstein JD, Obeleniene R. How Should Diuretic-Refractory, Volume Over-Loaded Heart Failure Patient Be Managed? J Invasive Cardiol 2003; 15: 585-590.

13. Epstein M, Lepp BA, Hoffman DS et al. Potentiation of furosemide by metolazone in refractory edema. Curr Ther Res 1977; 29: 367-372.

14. Massie BM. Management of the patient with chronic heart failure In: Crawford MH, DiMarco JP (eds). Cardiology. 2. ed. St. Louis: Mosby 2001 5.5.4-5.5.6

15. Butler J, Forman DE, Abraham WT et al. Relationship between heart failure treatment and development of worsening renal function among hospitalized patients. Am Heart J 2004; 147: 331-338.

16. Paul S. Balancing Diuretic Therapy in Heart Failure: Loop Diuretics, Thiazides, and Aldosterone Antagonists: {CHF} Congest Heart Fail 2002; 8: 307-312.

17. Widimský J. Srdeční selhání. Praha: Triton 2001: 110-112.

18. Šenke M, Eybl V, Hynie S et al. Farmakologie. Praha: Avicenum 1990: 358-369.

19. De Bruyne LKM. Mechanism and management of diuretic resistance in congestive heart failure. Postgrad Med J 2003; 79: 268-271.

20. Vítovec J, Špinar J, Souček M et al. Farmakoterapie kardiovaskulárních onemocnění. Praha: Grada 2004: 95-104.

21. Leslie D, Gheorgiade M. Is there a role for thiamine supplementation in the management o heart failure? Am Heart J 1996; 131: 1248-1250.

22. Simon I, Almog S, Vered Z et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995; 98: 485-490.

23. Dahlöf B, Sever PS, Poulter NR et al. Prevention of cardiovascular events with an antihypertensive regiment of amlodipine adding perindopril as required versus atenolol adding bendroflumetiazide as required in the Anglo-Scandinavian Outcomes Trial-Blood Pressure Lowering Arms (ASCOT-BPLA): a multicentre randomised controlled trial. The Lancet 2005; 366: 895-906.

24. Fliser D, Schröter M, Neubeck M et al. Coadministration of thiazides increases the efficacy of loop diuretics even in patients with advanced renal failure. Kidney International 1994; 46: 482-488.

25. Brater DC. Diuretic Therapy. N Engl J Med 1998; 339: 387-395.

26. Knauf H, Mutschler E. Functional State of Nephron and Diuretic Dose-Response-Rationale for Low-Dose Combination Therapy. Cardiology 1994; 84 (Suppl 2): 18-26.

27. Pitt B, Zannad F, Remme WJ et al. Randomized Aldacton Evaluation Study Investigators. N Engl J Med 1999; 341: 709-717.

28. Pitt B, Remme W, Zannad F et al. Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study. N Engl J Med 2003; 348: 1309-1321.

29. Van Vliet AA, Donker AJM, Nauta JJP et al. Spironolactone in congestive heart failure refractory to high-dose of loop diuretic and low-dose angiotensin-converging enzyme inhibitor. Am J Cardiol 1993; 71: 21A-28A.

30. Loon NR, Wilcox ChS, Undin RJ. Mechanism of impaired natriuretic response to furosemide during prolonged therapy. Kidney Int 1989; 36: 682-689.

31. Ellison DH, Velazquez H, Wright FS et al. Adaptation of the Distal Convoluted Tubule of the Rat, structural and functional effects of dietary salt intake and chronic diuretic infusion. J Clin Invest 1989; 83: 113-126.

32. Lawson DA, Gray JM, Henry DA et al. Continuous infusion furosemide in refractory edema. Br Med J 1978; 2: 476.

33. Rudy DV, Voelker JR, Greene PK et al. Loop Diuretics for Chronic Renal Insufficiency: A Continuous Infusion is More Effficacious Than Bolus Therapy. Ann Intern Med 1991; 115: 360-366.

34. Shück O. Poruchy metabolismu vody a elektrolytů v klinické praxi. Praha: Grada 2000: 81-82, 95-105.

35. Elwell JR, Spenser PA, Eisele G. Combined Furosemide and Human Albumin Treatment for Diuretic-Resistant Edema. Ann Pharmacother 2003; 37: 695-700.

36. Davison AM, Cameron S, Grünfeld JP et al. Oxford Textbook of Clinical Nefrology. Oxford: Oxford University Press 2005: 1485, 2630.

37. Agostoni P, Marenzi G, Pepi M et al. Isolated ultrafiltration in moderate congestive heart failure. J Am Coll Cardiol 1999; 21: 424-431.

38. Agostoni P, Marenzi G, Lauri G et al. Sustained improvement in functional capacity after removal of body fluid with isolated ultrafiltration in chronic cardiac insufficiency. Am J Med 1994; 96: 191-199.