Abstract
Heart failure is an epidemic of ageing 21st century societies. Despite wide access to modern treatment strategies, many
cardiovascular diseases eventually lead to its development. Especially increased survival after acute coronary syndrome
contributes to the growing number of patients with heart failure. Despite the use of optimal pharmacological treatment and
therapeutic support devices (i.e. cardiac resynchronisation), heart failure manifests in a number of exacerbations, often
requiring hospitalisation. The most common cause of symptom exacerbation is volume overload, which might result from
disease progression, comorbidities and patient non-compliance, e.g. regarding drug withdrawal or dose reduction. Moreover,
each hospitalisation deteriorates prognosis. It is therefore important to optimise pharmacological treatment to improve both
survival and symptoms. The main group of symptom-relieving drugs in heart failure are diuretics, which relieve congestionrelated
symptoms, improve the quality of life and reduce the risk of further hospitalisations. However, they do not affect
prognosis. Moreover, they are not free from limitations, and the desired effect of dehydration can be associated with adverse
effects, i.e. impaired renal function. It is therefore important to use the lowest possible doses, sufficient to maintain
euvolaemia. The aim of this paper is to summarise the current knowledge concerning the safe use of diuretics, based on the
understanding of their mechanisms of action and rules of application in various phases of the disease.
Citation
ID:
232932
Ref Key:
galas2017pediatriadiuretics