دورية أكاديمية

Proximal versus distal diuretics in congestive heart failure

التفاصيل البيبلوغرافية
العنوان: Proximal versus distal diuretics in congestive heart failure
المؤلفون: Nardone, Massimo, Sridhar, Vikas S, Yau, Kevin, Odutayo, Ayodele, Cherney, David Z I
المصدر: Nephrology Dialysis Transplantation ; ISSN 0931-0509 1460-2385
بيانات النشر: Oxford University Press (OUP)
سنة النشر: 2024
مصطلحات موضوعية: Transplantation, Nephrology
الوصف: Volume overload represents a hallmark clinical feature linked to the development and progression of heart failure (HF). Alleviating signs and symptoms of volume overload represents a foundational HF treatment target that is achieved using loop diuretics in the acute and chronic setting. Recent work has provided evidence to support guideline-directed medical therapies, such as sodium glucose cotransporter 2 (SGLT2) inhibitors and mineralocorticoid receptor (MR) antagonists, as important adjunct diuretics that may act synergistically when used with background loop diuretics in people with chronic HF. Furthermore, there is growing interest in understanding the role of SGLT2 inhibitors, carbonic anhydrase inhibitors, thiazide diuretics, and MR antagonists in treating volume overload in patients hospitalized for acute HF, particularly in the setting of loop diuretic resistance. Thus, the current review demonstrates that: 1) SGLT2 inhibitors and MR antagonists confer long-term cardioprotection in chronic HF patients but it is unclear if natriuresis or diuresis represents the primary mechanisms for this benefit, 2) SGLT2 inhibitors, carbonic anhydrase inhibitors, and thiazide diuretics increase natriuresis in the acute HF setting, but implications on long-term outcomes remain unclear and warrants further investigation, and 3) a multi-nephron segment approach, using agents that act on distinct segments of the nephron, potentiate diuresis to alleviate signs and symptoms of volume overload in acute HF.
نوع الوثيقة: article in journal/newspaper
اللغة: English
DOI: 10.1093/ndt/gfae058
DOI: 10.1093/ndt/gfae058/56809730/gfae058.pdf
الإتاحة: https://doi.org/10.1093/ndt/gfae058Test
حقوق: https://creativecommons.org/licenses/by/4.0Test/
رقم الانضمام: edsbas.3AC48DC3
قاعدة البيانات: BASE