Treating Diuretic Resistance in Light of New Evidence

Abstract

Nearly 80% of all patients hospitalized for decompensated heart failure (HF) present hypervolemia with signs and symptoms of congestion, 1,2 for which decongestion is an essential pillar of treatment. Most guidelines recommend the use of loop diuretics as soon as the patient is admitted. [3][4][5] Despite this, a post-hoc analysis of the DOSE-AHF and CARRESS-HF studies showed that only half of these patients were free of congestion at the moment of high discharge, this being the group with the highest mortality and readmission rates within 60 days. 2