Key result
Optimizing diuretics or renal replacement therapy manages complex heart-kidney-lung fluid balance in HF.
Why the study?
Fluid retention is a major determinant of symptoms and prognosis in HF, but the underlying pathophysiology of fluid balance involving the heart, kidney, and lung is complex.
Fluid balance in heart failure involves a complex interplay between the heart, kidney, and lung, requiring optimized diuretic therapy or renal replacement therapy for congestion relief.
Supports multidisciplinary congestion management in heart failure; leaves open optimal diuretic and renal replacement strategies.
Fluid retention is a major determinant of symptoms in patients with heart failure (HF), and it is closely associated with prognosis. Hence, congestion represents a critical therapeutic target in this clinical setting. The first therapeutic strategy in HF patients with fluid overload is optimization of diuretic intervention to maximize water and sodium excretion. When diuretic therapy fails to relieve congestion, renal replacement therapy represents the only alternative option for fluid removal, as well as a way to restore diuretic responsiveness. On this background, the pathophysiology of fluid balance in HF is complex, with heart, kidney, and lung being deeply involved in volume regulation and management. Therefore, the interplay between these organs should be appreciated and considered when fluid overload in HF patients is targeted.
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Cosentino et al. (2023) conducted a review in Heart failure with fluid overload. Diuretic therapy and renal replacement therapy was evaluated. Fluid balance in heart failure involves complex interactions between the heart, kidney, and lung, requiring optimization of diuretic therapy or renal replacement therapy for congestion management.
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