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Current Pharmaceutical Design


ISSN (Print): 1381-6128
ISSN (Online): 1873-4286

Review Article

Overview of the Treatment of Congestion in Heart Failure

Author(s): Julia Martinez-Sole, Jose Carlos Sanchez-Martinez, Raquel Lopez-Vilella, Victor Donoso-Trenado, Ignacio Sanchez-Lazaro, Luis Almenar-Bonet, Jorge Sanz-Sanchez* and Luis Martinez-Dolz*

Volume 29, Issue 20, 2023

Published on: 20 July, 2023

Page: [1592 - 1601] Pages: 10

DOI: 10.2174/1381612829666230714153404

Price: $65


Heart failure is a major problem in developed countries, leading to a high number of hospitalizations and healthcare costs. The most common symptom of heart failure is congestion, which is also the primary reason for hospitalization. Diuretics, particularly loop diuretics, are the cornerstone of the treatment of congestion. Likewise, there are other types of diuretics with different pathways of action, bioavailability profiles, adverse reactions, and effects on the cardiovascular and renal systems. Moreover, in recent years, new therapeutic alternatives have been proposed for challenging cases of diuretic resistance, such as ultrafiltration through peripheral access or peritoneal dialysis. The main objective of this article is to provide a step-guided approach to the management of congestion in patients with heart failure in order to guide the medical practice. Despite the significant amount of research published in recent years, there are no clear algorithms for managing acute heart failure. Diuretics remain the primary treatment of acute heart failure, and nephron blockade is key, but new therapies are emerging, and ongoing research is needed to develop better strategies for managing this condition.

Keywords: Acute heart failure, congestion, diuretics, diuretic refractoriness, nephron blockade, heart failure, loop diuretics, thiazide diuretics, sodium-glucose cotransporter 2 inhibitor, peritoneal dialysis, ultrafiltration.

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