Diuretics Advantages and Disadvantages in Edematous Conditions PDF

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diuretics congestive heart failure chronic kidney disease medicine

Summary

This document discusses the advantages and disadvantages of diuretics in treating edematous conditions, such as congestive heart failure and chronic kidney disease. It highlights the correction of fluid retention, lowering of blood pressure, and improvement of cardiac contraction as benefits. Potential risks include hypovolemia and electrolyte imbalances.

Full Transcript

Advantages and disadvantages of diuretics in some Part 3: edematous conditions █ CONGESTIVE HEART FAILURE (CHF) Patients with CHF have ↓COP due to weak cardiac muscle, fluid retention, and lung congestion. Many patients have also high blood pre...

Advantages and disadvantages of diuretics in some Part 3: edematous conditions █ CONGESTIVE HEART FAILURE (CHF) Patients with CHF have ↓COP due to weak cardiac muscle, fluid retention, and lung congestion. Many patients have also high blood pressure. Advantages of diuretics: – Correction of fluid retention. – Lowering of blood pressure. – Decrease preload (venodilatation and ↓ venous return) and afterload (due to arterial VD) leads to improvement of cardiac contraction. – Decrease lung congestion causes improvement of tissue oxygenation. – Recent evidence showed that spironolactone reduces morbidity and mortality rates in patients with advanced heart failure. Disadvantages of diuretics: Recommendation: – Excessive hypovolemia can ↓ COP. Combination – Diuretic-induced acid-base and electrolyte between a K+ sparing diuretic and imbalance may impair cardiac function. loop diuretic is the – Diuretic-induced hypokalemia can predispose to best choice. digitalis toxicity and cardiac arrhythmia. █ CHRONIC KIDNEY DISEASES The majority of patients with chronic renal diseases (e.g. chronic renal failure, diabetic nephropathy, etc.) have fluid retention, hypertension, hyperkalemia, and acidosis. Advantages of diuretics: Recommendation: – Correction of fluid retention. Loop diuretics are – Reduction of hyperkalemia. best choice. – Reduction of hypertension. Disadvantages of diuretics: – Thiazides are ineffective when GFR is

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