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Diuretics in chf

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https://www.readbyqxmd.com/read/30087772/medication-discrepancies-in-late-stage-chronic-kidney-disease
#1
Jamil Ibrahim, Azzour D Hazzan, Anna T Mathew, Vipul Sakhiya, Meng Zhang, Candice Halinski, Steven Fishbane
Background: Late-stage chronic kidney disease (LS-CKD) can be defined by glomerular filtration rate (GFR) 0-30 mL/min. It is a period of risk for medication discrepancies because of frequent hospitalizations, fragmented medical care, inadequate communication and polypharmacy. In this study, we sought to characterize medication discrepancies in LS-CKD. Methods: We analyzed all patients enrolled in Northwell Health's Healthy Transitions in LS-CKD program. All patients had estimated GFR 0-30 mL/min, not on dialysis...
August 2018: Clinical Kidney Journal
https://www.readbyqxmd.com/read/30052224/refractory-hypokalemia-while-weaning-off-bypass
#2
Rashmi Soori, Aanchal Dixit, Prabhat Tewari
Hypokalemia is defined as serum potassium level less than 3.5 mEq/L. When the serum level of potassium is less than 3 mEq/L, intravenous potassium supplementation is warranted. A 23 yr old adult female with complaints of dyspnoea (NYHA II) since 6 yrs, dyspnoea (NYHA III) and paroxysmal nocturnal dyspnoea on and off since 2 months, diagnosed with severe mitral stenosis, was posted for mitral valve replacement. After the release of ACC, ECG revealed sine wave pattern, Transesophageal echocardiographic examination revealed global hypokinesia and ABG showed potassium of 2...
July 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/30033126/an-evaluation-of-a-potential-calcium-channel-blocker-lower-extremity-edema-loop-diuretic-prescribing-cascade
#3
Scott Martin Vouri, Joseph S van Tuyl, Margaret A Olsen, Hong Xian, Mario Schootman
OBJECTIVES: Dihydropyridine calcium channel blockers (DH-CCB) are associated with lower-extremity edema (LEE). Loop diuretics have been used inappropriately to treat DH-CCB-associated LEE, constituting a prescribing cascade (PC). The aim of this work was to identify the prevalence and factors associated with potential DH-CCB-LEE-loop diuretic PC. METHODS: The 2014 National Ambulatory Medical Care Survey was used to identify patient visits in which a DH-CCB was continued...
July 20, 2018: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/29943886/low-serum-chloride-in-patients-with-chronic-heart-failure-clinical-associations-and-prognostic-significance
#4
Joseph J Cuthbert, Pierpaolo Pellicori, Alan Rigby, Daniel Pan, Syed Kazmi, Parin Shah, Andrew L Clark
BACKGROUND: Low serum chloride is common in patients with chronic heart failure (CHF) and is associated with worse outcomes. We investigated the clinical and prognostic associations, including cause of death associations, of low serum chloride in patients referred to a secondary care clinic with suspected heart failure. METHODS AND RESULTS: Patients with echocardiogram and serum chloride were evaluated (n = 5613). CHF was defined as signs and symptoms of the disease and either left ventricular systolic dysfunction (LVSD) worse than mild [heart failure with reduced ejection fraction (HFrEF)] or LVSD mild or better and raised amino-terminal pro-B-type natriuretic peptide (NT-proBNP) levels (>125 ng/L) [heart failure with preserved ejection fraction (HFpEF)]...
June 26, 2018: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29896315/novel-concept-to-guide-systolic-heart-failure-medication-by-repeated-biomarker-testing-results-from-time-chf-in-context-of-predictive-preventive-and-personalized-medicine
#5
Nasser Davarzani, Sandra Sanders-van Wijk, Micha T Maeder, Peter Rickenbacher, Evgueni Smirnov, Joël Karel, Thomas Suter, Rudolf A de Boer, Dirk Block, Vinzent Rolny, Christian Zaugg, Matthias E Pfisterer, Ralf Peeters, Hans-Peter Brunner-La Rocca
Background: It is uncertain whether repeated measurements of a multi-target biomarker panel may help to personalize medical heart failure (HF) therapy to improve outcome in chronic HF. Methods: This analysis included 499 patients from the Trial of Intensified versus standard Medical therapy in Elderly patients with Congestive Heart Failure (TIME-CHF), aged ≥ 60 years, LVEF ≤ 45%, and NYHA ≥ II, who had repeated clinical visits within 19 months follow-up...
June 2018: EPMA Journal
https://www.readbyqxmd.com/read/29870433/associations-between-relevant-cardiovascular-pharmacotherapies-and-incident-heart-failure-in-patients-with-atrial-fibrillation-a-cohort-study-in-primary-care
#6
Per Wändell, Axel C Carlsson, Martin J Holzmann, Johan Ärnlöv, Jan Sundquist, Kristina Sundquist
OBJECTIVE: To study association between relevant cardiovascular pharmacotherapy and incident congestive heart failure (CHF) in patients with atrial fibrillation treated in primary health care. METHODS: Study population included all adults (n = 7975) aged 45 years and older diagnosed with atrial fibrillation at 75 primary care centers in Sweden between 2001 and 2007. Outcome was defined as a first diagnosis of CHF post-atrial fibrillation diagnosis. Association between CHF and treatment with relevant cardiovascular pharmacotherapies (beta blockers, calcium blockers, digitalis, diuretics, RAS blockers, and statins) was explored using Cox regression analysis with hazard ratios and 95% CIs...
June 4, 2018: Journal of Hypertension
https://www.readbyqxmd.com/read/29846031/pharmacy-based-interdisciplinary-program-for-patients-with-chronic-heart-failure-pharm-chf-rationale-and-design-of-a-randomized-controlled-trial-and-results-of-the-pilot-study
#7
Ulrich Laufs, Nina Griese-Mammen, Katrin Krueger, Angelika Wachter, Stefan D Anker, Friedrich Koehler, Volker Rettig-Ewen, Lea Botermann, Dorothea Strauch, Dietmar Trenk, Michael Böhm, Martin Schulz
We report the rationale and design of a community PHARMacy-based prospective randomized controlled interdisciplinary study for ambulatory patients with Chronic Heart Failure (PHARM-CHF) and results of its pilot study. The pilot study randomized 50 patients to a pharmacy-based intervention or usual care for 12 months. It demonstrated the feasibility of the design and showed reduced systolic blood pressure in the intervention group as indicator for improved medication adherence. The main study will randomize patients ≥60 years on stable pharmacotherapy including at least one diuretic and a history of heart failure hospitalization within 12 months...
May 30, 2018: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29770976/pharmacokinetic-and-pharmacodynamic-properties-of-orally-administered-torsemide-in-healthy-horses
#8
Gustavo F Agne, Seung Woo Jung, Anne A Wooldridge, Susan H Duran, William Ravis, Ramiro Toribio
BACKGROUND: Diuretic treatment is the mainstay for management of congestive heart failure in horses, and its use has been restricted to injectable medications because no currently data supports the use of PO administered loop diuretics. OBJECTIVES: To determine the pharmacokinetic and pharmacodynamic properties of PO administered torsemide and, determine if PO administered torsemide, could be used as an alternative to injectable diuretics in the horse. ANIMALS: Six healthy adult mares...
May 17, 2018: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/29763317/chemoproteomic-profiling-reveals-ethacrynic-acid-targets-adenine-nucleotide-translocases-to-impair-mitochondrial-function
#9
Zi Ye, Xiaoyun Zhang, Yuangang Zhu, Tong Song, Xiaowei Chen, Xiaoguang Lei, Chu Wang
Ethacrynic acid (EA) is a diuretic drug that is widely used to treat high-blood pressure and swelling caused by congestive heart failure or kidney failure. It acts through noncovalent inhibition of the Na+ -K+ -2Cl- cotransporter in the thick ascending limb of Henle's loop. Chemically, EA contains a Michael acceptor group that can react covalently with nucleophilic residues in proteins; however, the proteome reactivity of EA remains unexplored. Herein, we took a quantitative chemoproteomic approach to globally profile EA's targets in cancer cells...
June 4, 2018: Molecular Pharmaceutics
https://www.readbyqxmd.com/read/29701173/cyclical-cardiorenal-syndrome-in-late-stage-kidney-disease
#10
Benson Ku, Steven Fishbane
INTRODUCTION: In patients with late-stage chronic kidney disease (LS-CKD, estimated glomerular filtration rate (eGFR) < 30 mL/min) there is a high prevalence of congestive heart failure (CHF). We have observed a cyclical nature in the "cardiorenal syndrome" in LS-CKD, not previously described. The purpose of this article is to describe the syndrome and review its characteristics. MATERIALS AND METHODS: Patients enrolled in the Northwell Health Healthy Transitions in Late Stage Kidney Disease Program (HT) were followed, all with eGFR 0 - 30 mL/min...
April 27, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/29684381/serum-chloride-as-a-novel-marker-for-adding-prognostic-information-of-mortality-in-chronic-heart-failure
#11
Yang Zhang, Rui Peng, Xinqiang Li, Jinxing Yu, Xi Chen, Zhou Zhou
BACKGROUND: Serum chloride concentrations have clinical significance in the prognosis of heart failure (HF). Little is known regarding the prognostic value of serum chloride in patients with chronic heart failure (CHF). This study sought to investigate the prognostic ability of admission serum chloride for long-term mortality in CHF patients. METHODS: We identified 1021 consecutive patients diagnosed with CHF. Participants were followed up for all-cause mortality at 21 ± 9 months to establish the survival models and analyze the association between admission serum chloride concentrations and death risk...
August 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/29665203/tolvaptan-alleviates-excessive-fluid-retention-of-nephrotic-diabetic-renal-failure-unresponsive-to-furosemide
#12
Tesshu Takada, Tsuguto Masaki, Ayako Hoshiyama, Takuya Toki, Yuji Kamata, Masayoshi Shichiri
Patients with diabetic nephropathy develop nephrotic syndrome, and may show limited response to conventional therapy. They often require earlier initiation of renal replacement therapy because they become refractory to diuretics, and experience excessive fluid retention. We aimed to investigate the efficacy of tolvaptan, an oral arginine vasopressin type 2 receptor antagonist, in a case series of 14 severe diabetic renal failure patients who were severely refractory to maximal doses of furosemide and had excessive fluid retention despite preserved cardiac function and residual renal function...
April 17, 2018: Nephrology
https://www.readbyqxmd.com/read/29655477/cardiovascular-drugs-in-avian-small-mammal-and-reptile-medicine
#13
Brenna Colleen Fitzgerald, Sara Dias, Jaume Martorell
Cardiovascular disease, including congestive heart failure, pericardial disease, and atherosclerosis, is becoming increasingly better recognized in companion birds, small mammals, and reptiles. A wide range of medications is available to treat these conditions, including diuretics, vasodilators, positive and negative inotropes, antiarrhythmic agents, and pentoxifylline. This review systematically discusses each of these drug classes and their potential applications in exotic species. Although treatment approaches remain largely empirical and extrapolated from small animal and human medicine, the management strategies presented here have the potential to both maintain quality of life and extend survival time for the exotic cardiac patient...
May 2018: Veterinary Clinics of North America. Exotic Animal Practice
https://www.readbyqxmd.com/read/29643894/characteristics-of-clinical-drugs-for-elderly-chronic-heart-failure-complicated-with-different-degrees-of-renal-insufficiency
#14
Hepeng Yu, Jing Chang, Wenwen Zhong, Ping Ye
Objective: To investigate the characteristics of clinical therapeutic drugs in elderly chronic heart failure (CHF) patients complicated with different degrees of renal insufficiency. Methods: The elderly patients who were hospitalized from October 2010 to October 2015 in our hospital due to CHF for the first time were selected by means of retrospective case collection. The glomerular filtration rate was estimated by using the Modification of Diet in Renal Disease (MDRD) Study equation...
January 2018: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29587582/spironolactone-to-increase-natriuresis-in-congestive-heart-failure-with-cardiorenal-syndrome
#15
Frederik H Verbrugge, Pieter Martens, Koen Ameloot, Veerle Haemels, Joris Penders, Matthias Dupont, W H Wilson Tang, Walter Droogné, Wilfried Mullens
BACKGROUND: Signs and symptoms of volume overload are the most frequent reason for hospital admission in acute heart failure (AHF). Diuretics are mainstay treatment, but their optimal type and dose regimen remain unclear, especially in patients with cardiorenal syndrome. METHODS: This prospective study aimed to include 80 AHF patients with volume overload and cardiorenal syndrome. Through a 2 × 2 factorial design, patients were randomised towards (1) combinational treatment with acetazolamide and low-dose loop diuretics versus high-dose loop diuretics; and (2) open-label oral spironolactone 25 mg OD given upfront versus at discharge...
March 27, 2018: Acta Cardiologica
https://www.readbyqxmd.com/read/29572286/add-on-antihypertensive-medications-to-angiotensin-aldosterone-system-blockers-in-diabetes-a-comparative-effectiveness-study
#16
Emily B Schroeder, Michel Chonchol, Susan M Shetterly, J David Powers, John L Adams, Julie A Schmittdiel, Gregory A Nichols, Patrick J O'Connor, John F Steiner
BACKGROUND AND OBJECTIVES: In individuals with diabetes, the comparative effectiveness of add-on antihypertensive medications added to an angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker on the risk of significant kidney events is unknown. DESIGN, SETTING PARTICIPANTS, & MEASUREMENTS: We used an observational, multicenter cohort of 21,897 individuals with diabetes to compare individuals who added β -blockers, dihydropyridine calcium channel blockers, loop diuretics, or thiazide diuretics to angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers...
May 7, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29570241/acute-cardiac-events-in-severe-community-acquired-pneumonia-a-multicenter-study
#17
Aykut Cilli, Ozlem Cakin, Emine Aksoy, Feyza Kargin, Nalan Adiguzel, Zuhal Karakurt, Begum Ergan, Seda Mersin, Selen Bozkurt, Fatma Ciftci, Melike Cengiz
INTRODUCTION: An increased risk of cardiovascular complications has been defined in community-acquired pneumonia (CAP), but limited data is available for patients with severe CAP. OBJECTIVE: The aim of the present study was to define the prevalence, characteristics, risk factors and impact on mortality of acute cardiac events in patients with severe CAP during short and long term. METHOD: This investigation was a multicenter, retrospective cohort sudy of patients with severe CAP...
March 23, 2018: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29557615/-tolvaptan-in-a-pediatric-cardiorenal-syndrome-what-is-its-role
#18
M Angeles Tejero Hernández, Elena García Martínez, M José Arroyo Marin, Elena Gómez Guzmán
The cardiorenal syndrome has been defined as a situation in which therapy to relieve congestive symptoms of heart failure is limited by a decreased renal function. The resistance to conventional diuretic treatment makes difficult managing these patients. Tolvaptan, a selective vasopressin-2 receptor antagonist, has been used successfully in adults with this pathology but the experience with children is very limited. A five-year-old girl with renal failure waiting for a heart transplant is presented. Tolvaptan (0...
April 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29526184/chronic-heart-failure
#19
Frank Edelmann, Christoph Knosalla, Klaus Mörike, Christiane Muth, Peggy Prien, Stefan Störk
BACKGROUND: Chronic heart failure (CHF) is the most common reason for hospital admissions in Germany. For the National Disease Management Guideline (NDMG) on CHF, a multidisciplinary expert panel revised the chapters on drug therapy, invasive therapy, and care coordination, following the methods of evidence-based medicine. METHODS: Recommendations are based on international guideline adaptations or systematic literature search. They were developed by a multidisciplinary expert panel, approved in a formal consensus procedure, and tested in open consultation, as specified by the requirements for S3 guidelines...
February 23, 2018: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29516511/transfusion-associated-circulatory-overload-prevention-a-retrospective-observational-study-of-diuretic-use
#20
Y Lin, R Cohen, C Armali, J Callum, C Cserti-Gazdewich, L Lieberman, J Pendergrast
BACKGROUND AND OBJECTIVES: Approaches to preventing transfusion-associated circulatory overload (TACO) include the use of diuretics. The purpose of this study was to determine how commonly diuretics are prescribed in patients receiving a red-blood-cell (RBC) transfusion. MATERIALS AND METHODS: This was a retrospective study of 200 adult inpatient RBC transfusion orders, 50 consecutive at each of four academic institutions. Only the first transfusion order for each patient was included...
May 2018: Vox Sanguinis
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