diuretic resistance

Introduction

diuretic resistance is > 240 mg furosemide equivalent daily

Etiology

• renal failure, cardiorenal syndrome

Pathology

• delayed peak concentrations of loop diuretics in the renal tubules
• increasing loop diuretic can stimulate sodium & water retention in downstream nephrons

Management

• metolazone 5 mg bid while maintaining loop diuretic dose
• tolvalptin 30 mg qd associated with less hyponatremia than metolazone
• increasing loop diuretic can worsen symptoms of fluid overload

More general terms

• drug adverse effect(s)

Additional terms

• diuretic