Diuretic resistance in decompensated chronic heart failure: trying to get out of the “loop”

Excerpt

Although the advances due to the development of new therapies in the last 2 decades, chronic heart failure (CHF) represents so far a major healthcare issue, taking into account its high prevalence, the frequent presence of associated comorbidities and the still poor outcomes [1]. Frequent rehospitalizations for fluid overload and congestion often occur in patients in CHF, also being associated with an impaired quality of life and their related costs for healthcare systems [2]. Loop-diuretics are the cornerstone of the management of congestion in acute decompensated CHF [3], albeit their effects are often limited by the occurrence of diuretic resistance (DR), a condition defined as the presence of symptoms and signs of congestion despite appropriate diuretic dose. …