Cardiovascular Endocrinology

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Cardiovascular Endocrinology:
doi: 10.1097/XCE.0000000000000013
Case report

Glucocorticoids completely reverse refractory diuretic resistance in a patient with decompensated heart failure and gross edema

Liu, Chao; Tian, Li; Liu, Kunshen

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Diuretic resistance is not uncommon in severe congestive heart failure patients. In most cases, diuretic resistance can be overcome by intravenous administration of a high dose of loop diuretics. Here we report the use of glucocorticoids to reverse refractory diuretic resistance in a congestive heart failure patient who failed with intravenous administration of a high dose of furosemide (1000 mg/day). A 65-year-old man with a history of triple vessel disease and systolic ventricular dysfunction developed refractory diuretic resistance. The glucocorticoids slowly but dramatically reversed diuretic resistance. As a result, there was a dramatic improvement in his renal function. The maximum daily urine output was 8950 ml/day on day 8. The average daily output was 5636 ml/day. Finally, the patient lost 42 kg of his body weight. Potential mechanisms using glucocorticoids to revert diuretic resistance are also discussed.

© 2013Wolters Kluwer Health Lippincott Williams Wilkins

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