title: [Diuretic therapy in heart failure].
abstract: Many of the primary clinical manifestations of heart failure (HF) are due to fluid retention, and treatments targeting congestion play a central role in HF management. Diuretic therapy remains the cornerstone of congestion treatment, and diuretics are prescribed to the majority of HF patients. Despite this ubiquitous use, there is limited evidence from prospective randomized studies to guide the use of diuretics. With the chronic use of diuretic and usually in advanced stages of HF, diuretics may fail to control salt and water retention. This review describes the mechanism of action of available diuretic classes, reviews their clinical use based on scientific evidence and discusses strategies to overcome diuretic resistance.
authors.affiliation: Servicio de Medicina Interna, Hospital Sant Jaume d'Olot, Universitat de Girona, Girona, España. Electronic address: jctv5153@comg.cat.
authors.forename: Joan Carles
authors.initials: JC
authors.lastname: Trullàs
authors.affiliation: Servicio de Medicina Interna, Hospital Universitari Arnau de Vilanova, Lleida, España.
authors.forename: José Luís
authors.initials: JL
authors.lastname: Morales-Rull
authors.affiliation: Servicio de Medicina Interna, Hospital Universitari de Bellvitge-Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España.
authors.forename: Francesc
authors.initials: F
authors.lastname: Formiga
mesh_terms: D002257:Carbonic Anhydrase Inhibitors / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D004231:Diuresis / Q000187:drug effects; D004232:Diuretics / Q000009:adverse effects / Q000145:classification / Q000493:pharmacokinetics / Q000627:therapeutic use*; D062865:Diuretics, Potassium Sparing / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D004351:Drug Resistance; D019317:Evidence-Based Medicine; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D009318:Natriuresis / Q000187:drug effects; D016032:Randomized Controlled Trials as Topic; D049993:Sodium Chloride Symporter Inhibitors / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D049994:Sodium Potassium Chloride Symporter Inhibitors / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use
chemical_list: D002257:Carbonic Anhydrase Inhibitors; D004232:Diuretics; D062865:Diuretics, Potassium Sparing; D049993:Sodium Chloride Symporter Inhibitors; D049994:Sodium Potassium Chloride Symporter Inhibitors
keywords: Congestive Heart Failure; Diuretics; Diuréticos; Heart failure; Insuficiencia Cardiaca Congestiva; Insuficiencia cardiaca