Renal tubular resistance is the primary driver for loop diuretic resistance in acute heart failure.

ABSTRACT:

Background

Loop diuretic resistance is a common barrier to effective decongestion in acute heart failure (AHF), and is associated with poor outcome. Specific mechanisms underlying diuretic resistance are currently unknown in contemporary AHF patients. We therefore aimed to determine the relative importance of defects in diuretic delivery vs. renal tubular response in determining diuretic response (DR) in AHF.

Methods and results

Fifty AHF patients treated with intravenous bumetanide underwent a 6-h timed urine collection for sodium and bumetanide clearance. Whole-kidney DR was defined as sodium excreted per doubling of administered loop diuretic and represents the sum of defects in drug delivery and renal tubular response. Tubular DR, defined as sodium excreted per doubling

SUBMITTER: Ter Maaten JM 

PROVIDER: S-EPMC6231236 | biostudies-literature | 2017 Aug

REPOSITORIES: biostudies-literature