How to optimize the use of diuretics in patients with heart failure?

Kardiol Pol. 2023 Sep 18. doi: 10.33963/v.kp.97315. Online ahead of print.ABSTRACTConsidering the pathophysiology and the clinical presentation of heart failure, the use of diuretics or drugs with diuretic properties are indispensable for an adequate management of heart failure patients. However, in clinical practice, fluid expansion is often undiagnosed and diuretic therapy is not always adequately titrated. Today, several drug classes with diuretic properties are available in addition to classical thiazides, thiazide-like and loop diuretics. The purpose of this short review is to discuss the different ways to optimize diuretic therapy using currently available drugs. Several approaches are considered including the combination of diuretics to obtain a sequential nephron blockade, the use of a drug combining a blocker of the renin-angiotensin system (RAS) and an inhibitor of the metabolism of natriuretic peptides (ARNI), the prescription of potassium binders to enable the maintenance and up-titration of RAS blockers and mineralocorticoid antagonists and finally the use of inhibitors of the renal reabsorption of glucose through the sodium-glucose cotransporter 2 system. An optimal use of these various drug classes should enable to improve the quality of life and to reduce the need of hospitalizations and the mortality in heart failure patients.PMID:37718589 | DOI:10.33963/v.kp.97315
Source: Kardiologia Polska - Category: Cardiology Authors: Source Type: research