Loop diuretics in acute heart failure: beyond the decongestive relief for the kidney

摘要: Current goals in the acute treatment of heart failure are focused on pulmonary and systemic decongestion with loop diuretics as cornerstone therapy. Despite rapid relief symptoms patients decompensated failure, after intravenous use diuretics, these agents has been consistently associated adverse events, including hypokalemia, azotemia, hypotension, increased mortality. Two recent randomized trials have shown that continuous infusions did not offer benefit but were hyponatremia, prolonged hospital stay, rate readmissions. This is probably due to limitations congestion evaluation well deleterious effects linked drug administration, particularly at higher dosage. The impaired renal function often this extensively explored could deserve more specific studies. Several questions remain be answered about best diuretic modality global clinical impact during post-discharge period, role deterioration treatment. Thus, if a necessary part for then there must an approach allows personalization therapy optimal avoidance events.