Diuretic Resistance and Chronic Heart Failure

  • Alice Ravera
  • Jozine M. ter Maaten
  • Marco MetraEmail author


Diuretic resistance is a predictor of adverse outcome in acute and chronic heart failure. Failure of loop diuretic treatment to maintain euvolemia can precipitate acute decompensation of heart failure and hospitalization or emergency treatment. Diuretic resistance can develop because of multiple mechanisms leading to progressive volume overload and congestion. A timely detection of loop diuretic resistance is key to promptly adopt treatment strategies in order to restore an optimal fluid balance. Increased diuretic doses, changing route of administration from oral to intravenous, combined diuretic treatment are possible strategies that can be put in place to deal with diuretic resistance in patients with heart failure.

In this chapter early detection of congestion and treatment of loop diuretic resistance are discussed.


Diuretic resistance Congestion Loop diuretics Heart failure Cardio-renal syndrome Diuresis Sodium Treatment 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Alice Ravera
    • 1
  • Jozine M. ter Maaten
    • 2
  • Marco Metra
    • 1
    Email author
  1. 1.University of BresciaBresciaItaly
  2. 2.University of GroningenGroningenNetherlands

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