Diurethic resistance: mechanisms, medical tactics and prevention


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Resumo

Diuretics play an important role in modern clinical practice due to their unique mechanisms of action and ability to influence many pathological processes. This review focuses on the achievements and problems of diuretic therapy. Among the unsolved problems, particular attention should be paid to the development of «diuretic resistance», the frequency of which reaches 20-30% of cases. The leading reasons for the development of diuretic resistance in pathological conditions that occur with systemic edema, in particular, heart failure, chronic kidney disease and nephrotic syndrome, are discussed. During diuretic therapy, along with the characteristics of the pathological condition, it is necessary to take into account such parameters of pharmacokinetics as bioavailability, metabolic pathways and half-life, which play a key role in choosing a class of diuretics, their dosages and route of administration. Treatment approaches aimed at overcoming diuretic resistance and its prevention include «natriuretic» and «non-natriuretic» strategies, as well as ultrafiltration.

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Sobre autores

A. Dyadyk

Donetsk National Medical University n.a. Maksim Gorky

T. Kugler

Donetsk National Medical University n.a. Maksim Gorky

Email: kugler2@mail.ru
PhD, Teaching Assistant at the Department of Therapy, Faculty of Internship and Postgraduate Education

E. Schukina

Donetsk National Medical University n.a. Maksim Gorky

I. Rakitskaya

Donetsk National Medical University n.a. Maksim Gorky

S. Zborovsky

Donetsk National Medical University n.a. Maksim Gorky

Yu. Suliman

Donetsk National Medical University n.a. Maksim Gorky

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