About this episode

The episode discusses the clinical use of diuretics, focusing on recent research and strategies for managing heart failure and hypertension.

References Proximal Tubule-Specific Deletion of the NHE3 (Na+/H+ Exchanger 3) in the Kidney Attenuates Ang II (Angiotensin II)-Induced Hypertension in Mice Melanie is in love with this paper that shows that sodium retention  Bumetanide and furosemide in heart failure everyone agreed that we love this classic paper from Craig Brater on diuretics (and the source of figure 15-6).  Lety referenced the Cr x 20 formula, a strategy to multiply the serum creatinine by 20 to estimate the initial furosemide dose. We agreed that this is more appropriate than the House of God formula of age + BUN = dose (which may be so much higher).  Joel shared this excellent report Diuretic Optimization Strategies Evaluation (DOSE) trial: https://www.nejm.org/doi/full/10.1056/nejmoa1005419 Amy shared how much she likes the two hour urine sodium (or random urine sodium) Rapid and Highly Accurate Prediction of Poor Loop Diuretic Natriuretic Response in Patients With Heart Failure - PMC Anna shared  this paper which suggests that urinary sodium is more closely linked to outcome compared to urine volume  Natriuretic Response Is Highly Variable and Associated With 6-Month Survival…

People in this episode

Host: Channel Your Enthusiasm

Topics covered

• diuretics
• hypertension
• heart failure
• sodium retention
• urine sodium
• clinical strategies

Keywords

• diuretics
• hypertension
• heart failure
• sodium retention
• urine sodium
• NHE3
• Bumetanide
• furosemide
• creatinine
• DOSE trial

Mentioned in this episode

Organizations: NEJM

Books & works: Diuretic Optimization Strategies Evaluation (DOSE), Rapid and Highly Accurate Prediction of Poor Loop Diuretic Natriuretic Response in Patients With Heart Failure, Natriuretic Response Is Highly Variable and Associated With 6-Month Survival: Insights From the ROSE-AHF Trial, Sleep disordered breathing and nocturnal polyuria: nocturia and enuresis, classic paper from Craig Brater on diuretics, source of figure 15-6

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