Back to Search
Start Over
Use, misuse and abuse of diuretics
- Source :
- European journal of internal medicine. 39
- Publication Year :
- 2016
-
Abstract
- Resolution of edema requires a correct interpretation of body fluids-related renal function, to excrete the excess volume while restoring systemic hemodynamics and avoiding renal failure. In heart failure, the intensive diuresis should be matched by continuous fluids refeeding from interstitium to plasma, avoiding central volume depletion. The slowly reabsorbed ascites cannot refeed this contracted volume in cirrhosis: the ensuing activation of intrathoracic receptors, attended by increased adrenergic and Renin release, causes more avid sodium retention, producing a positive fluid and Na balance in the face of continuous treatment. High-dose-furosemide creates a defect in tubular Na causing diuresis adequate to excrete the daily water and electrolyte load in Chronic Renal Failure. Diuretic treatment requires care, caution and bedside "tricks" aimed at minimizing volume contraction by correctly assessing the homeostatic system of body fluids and related renal hemodynamics.
- Subjects :
- Liver Cirrhosis
medicine.medical_specialty
Cirrhosis
030232 urology & nephrology
Renal function
Diuresis
030204 cardiovascular system & hematology
Kidney
03 medical and health sciences
0302 clinical medicine
Internal medicine
Edema
Ascites
Renin–angiotensin system
Hyperaldosteronism
Internal Medicine
medicine
Humans
Plasma Volume
Diuretics
Heart Failure
business.industry
Water-Electrolyte Balance
medicine.disease
Endocrinology
Heart failure
Cardiology
Kidney Failure, Chronic
medicine.symptom
business
Hyponatremia
Subjects
Details
- ISSN :
- 18790828
- Volume :
- 39
- Database :
- OpenAIRE
- Journal :
- European journal of internal medicine
- Accession number :
- edsair.doi.dedup.....b61e2e3581fb9e90fd677ca5e66bfa38