title: Diuretic Strategies in Acute Decompensated Heart Failure.
abstract: The burden of heart failure in the United States is growing rapidly to epic proportions with serious clinical implications for patients and economic strain for healthcare systems. One of the most common reasons for hospitalization in acute decompensated heart failure (ADHF) is excess volume accumulation which leads to untoward symptoms including dyspnea,orthopnea, and edema.
  
  
  
  Over the past several decades, there has been great interest in exploring various decongestive strategies in order to achieve symptomatic improvement and favorable clinical outcomes. These include different modalities of loop diuretic administration, the adjunctive use of non-loop diuretics, and other diuretic sparing strategies. Herein, we provide an appraisal of these decongestive strategies and discuss novel concepts predicting clinical outcomes based on diuretic response and decongestive adequacy while discussing commonly encountered problems such as worsening renal function in ADHF.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9047, USA.
authors.forename: E Ashley
authors.initials: EA
authors.lastname: Hardin
authors.affiliation: Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9047, USA. Justin.Grodin@utsouthwestern.edu.
authors.forename: Justin L
authors.initials: JL
authors.lastname: Grodin
mesh_terms: D000208:Acute Disease; D004232:Diuretics / Q000627:therapeutic use*; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D007674:Kidney Diseases / Q000188:drug therapy; D049994:Sodium Potassium Chloride Symporter Inhibitors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
chemical_list: D004232:Diuretics; D049994:Sodium Potassium Chloride Symporter Inhibitors
keywords: Acute decompensated heart failure; Decongestive; Diuretic; Heart failure