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Diuretic Treatment for the Sodium Retention of Congestive Heart Failure

Diuretic Treatment for the Sodium Retention of Congestive Heart Failure Abstract The use of diuretics for the treatment of sodium retention in congestive heart failure was evaluated. Particular focus was given to the altered renal response to diuretics in patients with heart failure and adverse responses to diuretic therapy. Highlighted in-formation included historical aspects of the development of diuretics, mechanisms of sodium retention, the physiologic and clinical response to diuretics, and the altered pharmacokinetics and pharmacodynamics of diuretics in congestive heart failure. Despite more than 60 years of empiric diuretic use in heart failure, the actual database regarding the long-term efficacy, adverse effects, and altered mortality outcome in heart failure is relatively small. Existent pharmacokinetic and pharmacodynamic data are typically not collected within the context of heart failure efficacy trials. In addition to altered electrolyte transport and total-body electrolyte depletion, diuretics may be associated with adverse neurohormonal activation. Thus, guidelines for acute and long-term therapy with diuretics in heart failure remain somewhat empiric. Diuretics will remain a mainstay for the treatment of edema in congestive heart failure but must be accompanied by moderate sodium restriction. However, large clinical trials of diuretics would be necessary to demonstrate that improved clinical efficacy with edema reduction is not offset by adverse effects, which include electrolyte depletion, ventricular arrhythmias, and subsequent increased mortality. (Arch Intern Med. 1994;154:1905-1914) References 1. Binger MW, Keith NM. Effect of diuretics in different types of edema . JAMA . 1933;101:2009-2016.Crossref 2. Merrill AJ. Edema and renal blood flow in patients with chronic congestive heart failure: evidence of 'forward failure' on the primary cause of edema . J Clin Invest . 1946;25:389-399.Crossref 3. Duncan LE, Liddle GW, Bartter FC. The effect of changes in body sodium on extracellular fluid volume and aldosterone and sodium excretion by normal and edematous men . J Clin Invest. 1956;35:1299-1305.Crossref 4. Pugh LGC, Wyndham CL. The circulatory effects of mercurial diuretic in congestive heart failure . Clin Sci. 1949;8:19. 5. Laragh JH, Heinemann HO, Demartini FE. Effect of chlorothiazide on electrolyte transport in man: its use in the treatment of edema of congestive heart failure, nephrosis, and cirrhosis . JAMA . 1958; 166:145-152.Crossref 6. Birtch AG, Zakheim RM, Jones LG, Barger AC. Redistribution of renal blood flow produced by furosemide and ethacrynic acid . Circ Res. 1967; 21:869-878.Crossref 7. Kilcoyne MM, Schmidt DH, Cannon PJ. Intrarenal blood flow in congestive heart failure . Circulation . 1973;47:786-797.Crossref 8. Puschett JB, Rastegar A. Comparative study of the effects of metolazone and other diuretics on potassium excretion . Clin Pharmacol Ther. 1973; 15:397-405. 9. Davidson C, McLachlan MSF, Burkinshow L, Morgan DB. Effect of long-term diuretic treatment on body potassium in heart disease . Lancet . 1976; 2:1044-1047.Crossref 10. Davidov M, Kakaviatos N, Finnerty FA Jr. Intravenous administration of furosemide in heart failure . JAMA . 1967;200:824-829.Crossref 11. Caranford JH, McDaniel WS. Observation on mercurial diuretics . Ann Intern Med. 1935;8:1266-1273.Crossref 12. Cody RJ, Ljungman S, Covit AB, et al. Regulation of glomerular filtration rate in chronic congestive heart failure patients . Kidney Int. 1988;34:361-367.Crossref 13. Leithe ME, Magorien RD, Hermiller JB, Unverferth DV, Leier CV. Relationship between central hemodynamics and regional blood flow in normal subjects and in patients with congestive heart failure . Circulation . 1984;69:57-64.Crossref 14. Cody RJ. Neurohormonal influences in the pathogenesis of congestive heart failure . In: Weber K, ed. Heart Failure . Philadelphia, Pa: WB Saunders Co; 1989:73-86. 15. Francis GS, Goldsmith SR, Levine TB, Cohn JN. The neurohormonal axis in congestive heart failure . Ann Intern Med. 1984;101:370-377.Crossref 16. Anand IS, Ferrari R, Kalra GS, Wahi PL, Poole-Wilson PA. Edema of cardiac origin: studies of body water and sodium, renal function, hemodynamic indices, and plasma hormones in untreated congestive cardiac failure . Circulation . 1989;80:299-305.Crossref 17. Cody RJ, Atlas SA, Laragh JH, et al. Atrial natriuretic factor in normal subjects and heart failure patients: plasma levels and renal, hormonal and hemodynamic response to peptide infusion . J Clin Invest. 1986;78:1362-1374.Crossref 18. Cody RJ, Torre S, Clark M, Pondolfino K. Age-related hemodynamic, renal, and hormonal differences in patients with congestive heart failure . Arch Intern Med. 1989;149:1023-1028.Crossref 19. Pecker MS. Pathophysiologic effects and strategies for long-term diuretic treatment of hypertension . In: Laragh JH, Brenner BM, eds. Hypertension: Pathophysiology. Diagnosis and Management . New York, NY: Raven Press; 1990:2143-2167. 20. Skott O, Briggs JP. Direct demonstration of macula densa mediated renin secretion . Science . 1987; 237:1618-1620.Crossref 21. Cody RJ, Covit AB, Schaer GL, Laragh JH, Sealey JE, Feldschuh J. Sodium and water balance in chronic congestive heart failure . J Clin Invest. 1986;77:1441-1452.Crossref 22. Wilcox CS, Mitch WE, Kelly RA, et al. Response to furosemide, I: effect of salt intake and renal compensation . J Lab Clin Med. 1983;102:450-458. 23. Ellison D, Velazquez H, Wright FS. Adaptation of the distal convoluted tubule of the rat: structural and functional effects of dietary salt intake and chronic diuretic infusion . J Clin Invest. 1989;83:113-126.Crossref 24. Stanton B, Kaissling B. Adaptation of distal tubule and collecting duct to increased sodium delivery, II: Na+ and K+ transport . Am J Physiol. 1988;255:F1269-F1275. 25. Wilcox CS. Diuretics . In: Brenner BM, Rector FC Jr, eds. The Kidney . 4th ed. Philadelphia, Pa: WB Saunders Co; 1991;2:2133-2147. 26. Grantham JJ, Chonko AM. The physiologic basis and clinical use of diuretics . In: Brenner BM, Stein JH, eds. Contemporary Issues in Nephrology: Sodium and Water Homeostasis . New York, NY: Churchill Livingstone; 1978:178-211. 27. Lal S, Murtagw JG, Pollock AM, Fletcher E, Binnion PF. Acute hemodynamic effects of furosemide in patients with normal and raised left atrial pressures . Br Heart J. 1969;31:711-717.Crossref 28. Dikshit K, Vyden JK, Forrester JS, et al. Renal and extrarenal hemodynamic effects of furosemide in congestive heart failure after myocardial infarction . N Engl J Med. 1973;288:1087-1090.Crossref 29. Magrini F, Niarchos AP. Hemodynamic effects of massive peripheral edema . Am Heart J. 1983; 105:90-94.Crossref 30. Stampfer M, Epstein SE, Beiser DG, Braunwald E. Hemodynamic effects of diuresis at rest and during intense upright exercise in patients with impaired cardiac function . Circulation . 1968;37:900-911.Crossref 31. Francis GS, Siegel RM, Goldsmith SR, Olivari MT, Levine TB, Cohn JN. Acute vasoconstrictor response to intravenous furosemide in patients with chronic congestive heart failure . Ann Intern Med. 1985;103:1-6.Crossref 32. Ikram H, Chan W, Espiner EA, Nicholls MG. Hemodynamic and hormone responses to acute and chronic furosemide therapy in congestive heart failure . Clin Sci. 1980;59:443-449. 33. Kubo SH, Clark M, Laragh JH, Borer JS, Cody RJ. Identification of normal neurohormonal activity in mild congestive heart failure and stimulating effect of upright posture and diuretics . Am J Cardiol. 1987;60:1322-1328.Crossref 34. Bayliss J, Norell M, Canepa-Anson R, Sutton G, Poole-Wilson P. Untreated heart failure: clinical and neuroendocrine effects of introducing diuresis . Br Heart J. 1987;57:17-22.Crossref 35. Lant A. Diuretics: clinical pharmacology and therapeutic use (part 1) . Drugs . 1985;29:57-87.Crossref 36. Lant A. Diuretics: clinical pharmacology and therapeutic use (part 2) . Drugs . 1985;29:162-188.Crossref 37. Cook JA, Smith DE, Cornish LA, Tankanow RM, Nicklas JM, Hyneck ML. Kinetics, dynamics, and bioavailability of bumetanide in healthy subjects and patients with congestive heart failure . Clin Pharmacol Ther. 1988;44:487-500.Crossref 38. Cutter RE, Blair AD. Clinical pharmacokinetics of furosemide . Clin Pharmacokinet 1979;4:279-296.Crossref 39. Ward A, Heel RC. Bumetanide: a review of its pharmacodynamic and pharmacokinetic properties and therapeutic use . Drugs . 1984;28:426-464.Crossref 40. Weiner IM, Mudge GH. Diuretics and other agents employed in the mobilization of edema fluid . In: Goodman LS, Gilman AG, eds. The Pharmacologic Basis of Therapeutics . 7th ed. New York, NY: Macmillan Publishing Co Inc; 1985:887-907. 41. Brater DC. Clinical pharmacology of loop diuretics . Drugs . 1991;42( (suppl 3) ):14-22.Crossref 42. Friedel HA, Buckley MMT. Torsemide: a review of its pharmacological properties and therapeutic potential . Drugs . 1991;41:81-103.Crossref 43. Brater DC, Leinfelder J, Anderson SA. Clinical pharmacology of torsemide, a new loop diuretic . Clin Pharmacol Ther. 1987;42:187-192.Crossref 44. Cuvelier R, Pellegrin P, Lesne M, et al. Site of action of torsemide in man . Eur J Clin Pharmacol. 1986;31( (suppl) ):15-19.Crossref 45. Brater DC, Pressley RH, Anderson SA. Mechanism of the synergistic combination of metolazone and bumetanide . J Pharmacol Exp Ther. 1985;233:70-74. 46. Wollam GL, Tarazi RC, Bravo EL, Dustan HP. Diuretic potency of combined hydrochlorothiazide and furosemide therapy in patients with azotemia . Am J Med. 1982;72:929-938.Crossref 47. Oster JR, Epstein M, Smoller S. Combined therapy with thiazide-type and loop diuretic agents for resistant sodium retention . Ann Intern Med. 1983; 99:405-406.Crossref 48. Brater DC, Seiwell R, Anderson S. Absorption and disposition of furosemide in congestive heart failure . Kidney Int. 1982;22:171-176.Crossref 49. Brater DC, Day B, Burdette A, Anderson S. Bumetanide and furosemide in heart failure . Kidney Int. 1984;26:183-189.Crossref 50. Cook JA, Smith DE, Cornish LA, et al. Kinetics, dynamics, and bioavailability of bumetanide in healthy subjects and patients with congestive heart failure . Clin Pharmacol Ther. 1988;44:487-500.Crossref 51. Brater DC. Resistance to loop diuretics: why it happens and what to do about it . Drugs . 1985; 30:427-443.Crossref 52. Brater DC. Disposition and response to bumetanide and furosemide . Am J Cardiol. 1986; 57:20A-25A.Crossref 53. Ellison DH. The physiologic basis of diuretic synergism: its role in treating diuretic resistance . Ann Intern Med. 1991;114:886-894.Crossref 54. Vasko MR, Brown-Cartwright D, Knochel JP, et al. Furosemide absorption altered in decompensated congestive heart failure . Ann Intern Med. 1985;102:314-318.Crossref 55. Brater DC, Chennavasin P, Seiwell R. Furosemide in patients with heart failure: shift in dose-response curves . Clin Pharmacol Ther. 1980;28:182-186.Crossref 56. Beerman B, Groschinsky-Grind M. Pharmacokinetics of hydrochlorothiazide in patients with congestive heart failure . Br J Clin Pharmacol. 1979; 7:579-583.Crossref 57. Dyckner T, Wester PO. Plasma and skeletal muscle electrolytes in patients on long-term diuretic therapy for arterial hypertension and/or congestive heart failure . Acta Med Scand. 1987;222:231-236.Crossref 58. Holmes J, Kubo SH, Cody RJ, Kligfield P. Arrhythmias in ischemic and nonischemic dilated cardiomyopathy: prediction of mortality by ambulatory electrocardiography . Am J Cardiol. 1985;55:146-151.Crossref 59. Gradman A, Deedwania P, Cody R, et al. Predictors of total mortality and sudden death in mild to moderate heart failure . J Am Coll Cardiol. 1989;14:564-570.Crossref 60. Hlatky MA, Fleg JL, Hinton PC, et al. Physician practice in the management of congestive heart failure . J Am Coll Cardiol. 1986;8:966-970.Crossref 61. Pfeffer MA, Braunwald E, Moye LA, et al. Effects of captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction . N Engl J Med. 1992;327:669-677.Crossref 62. The SOLVD Investigators. Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions . N Engl J Med. 1992; 327:685-691.Crossref 63. Odemuyiwa O, Gilmartin J, Kenny D, Hall RJC. Captopril and the diuretic requirements in moderate and severe chronic heart failure . Eur Heart J. 1989;10:586-590. 64. Anand IS, Kalra GS, Ferrari R, Wahi PL, Harris PC, Poole-Wilson PA. Enalapril as initial and sole treatment in severe chronic heart failure with sodium retention . Int J Cardiol. 1990;28:341-346.Crossref 65. Richardson A, Bayliss J, Scriven AJ, Parameshwar J, Poole-Wilson PA, Sutton GC. Double blind comparison of captopril alone against furosemide plus amiloride in mild heart failure . Lancet . 1987;2: 709-711.Crossref 66. Ikram H, Webster MWI, Nicholls MG, Lewis GRJ, Richards AM, Crozier IG. Combined spironolactone and converting-enzyme inhibitor therapy for refractory heart failure . Aust N Z J Med. 1986;16:61-63.Crossref 67. Cody RJ. Clinical trials of diuretic therapy in congestive heart failure: research needs and clinical considerations . J Am Coll Cardiol. 1993;21 ( (suppl A) ):165A-171A.Crossref 68. Cody RJ. The need for a sodium retention score in clinical trials of heart failure . Clin Pharmacol Ther. 1993;54:7-10.Crossref 69. Channavasin P, Seiwell R, Brater DC. Pharmacokinetic-dynamic analysis of the indomethacin-furosemide interaction in man . J Pharmacol Exp Ther. 1980;215:77-81. 70. Brater DC. Resistance to diuretics: emphasis on a pharmacological perspective . Drugs . 1981;22:477-494.Crossref 71. Gerlag PG, Meijel J. High-dose furosemide in the treatment of refractory congestive heart failure . Arch Intern Med. 1988;148:286-291.Crossref 72. Copeland JG, Campbell DW, Plachetka JR, Salomon NW, Larson DF. Diuresis with continuous infusion of furosemide after cardiac surgery . Am J Surg. 1983;46:796-799.Crossref 73. Rudy DW, Voelker JR, Greene PK, Esparza FA, Brater DC. Loop diuretics for chronic renal insufficiency: a continuous infusion is more efficacious than bolus therapy . Ann Intern Med. 1991; 115:360-366.Crossref 74. Agostoni PG, Marenzi GD, Pepi M, et al. Isolated ultrafiltration in moderate congestive heart failure . J Am Coll Cardiol. 1993;21:424-431.Crossref 75. Rubin J, Ball R. Continuous ambulatory peritoneal dialysis as treatment of severe congestive heart failure in the face of chronic renal failure: report of eight cases . Arch Intern Med. 1986;146:1533-1535.Crossref 76. Schaer GL, Covit AB, Laragh JH, Cody RJ. Association of hyponatremia with increased renin activity in chronic congestive heart failure: impact of diuretic therapy . Am J Cardiol. 1983;51: 1635-1638.Crossref 77. Packer M, Medina N, Yushak H. Correction of dilutional hyponatremia in severe chronic heart failure by converting enzyme inhibition . Ann Intern Med. 1984;100:782-789.Crossref 78. Cody RJ, Franklin KW, Laragh JH. Postural hypotension during tilt with chronic captopril therapy of severe congestive heart failure . Am Heart J. 1982;103:480-484.Crossref 79. Cody RJ. Hemodynamic responses to specific renin angiotensin inhibitors in hypertension and heart failure: a review . Drugs . 1984;28:144-169.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Diuretic Treatment for the Sodium Retention of Congestive Heart Failure

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American Medical Association
Copyright
Copyright © 1994 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1994.00420170045004
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Abstract

Abstract The use of diuretics for the treatment of sodium retention in congestive heart failure was evaluated. Particular focus was given to the altered renal response to diuretics in patients with heart failure and adverse responses to diuretic therapy. Highlighted in-formation included historical aspects of the development of diuretics, mechanisms of sodium retention, the physiologic and clinical response to diuretics, and the altered pharmacokinetics and pharmacodynamics of diuretics in congestive heart failure. Despite more than 60 years of empiric diuretic use in heart failure, the actual database regarding the long-term efficacy, adverse effects, and altered mortality outcome in heart failure is relatively small. Existent pharmacokinetic and pharmacodynamic data are typically not collected within the context of heart failure efficacy trials. In addition to altered electrolyte transport and total-body electrolyte depletion, diuretics may be associated with adverse neurohormonal activation. Thus, guidelines for acute and long-term therapy with diuretics in heart failure remain somewhat empiric. Diuretics will remain a mainstay for the treatment of edema in congestive heart failure but must be accompanied by moderate sodium restriction. However, large clinical trials of diuretics would be necessary to demonstrate that improved clinical efficacy with edema reduction is not offset by adverse effects, which include electrolyte depletion, ventricular arrhythmias, and subsequent increased mortality. (Arch Intern Med. 1994;154:1905-1914) References 1. Binger MW, Keith NM. Effect of diuretics in different types of edema . JAMA . 1933;101:2009-2016.Crossref 2. Merrill AJ. Edema and renal blood flow in patients with chronic congestive heart failure: evidence of 'forward failure' on the primary cause of edema . J Clin Invest . 1946;25:389-399.Crossref 3. Duncan LE, Liddle GW, Bartter FC. The effect of changes in body sodium on extracellular fluid volume and aldosterone and sodium excretion by normal and edematous men . J Clin Invest. 1956;35:1299-1305.Crossref 4. Pugh LGC, Wyndham CL. The circulatory effects of mercurial diuretic in congestive heart failure . Clin Sci. 1949;8:19. 5. Laragh JH, Heinemann HO, Demartini FE. Effect of chlorothiazide on electrolyte transport in man: its use in the treatment of edema of congestive heart failure, nephrosis, and cirrhosis . JAMA . 1958; 166:145-152.Crossref 6. Birtch AG, Zakheim RM, Jones LG, Barger AC. Redistribution of renal blood flow produced by furosemide and ethacrynic acid . Circ Res. 1967; 21:869-878.Crossref 7. Kilcoyne MM, Schmidt DH, Cannon PJ. Intrarenal blood flow in congestive heart failure . Circulation . 1973;47:786-797.Crossref 8. Puschett JB, Rastegar A. Comparative study of the effects of metolazone and other diuretics on potassium excretion . Clin Pharmacol Ther. 1973; 15:397-405. 9. Davidson C, McLachlan MSF, Burkinshow L, Morgan DB. Effect of long-term diuretic treatment on body potassium in heart disease . Lancet . 1976; 2:1044-1047.Crossref 10. Davidov M, Kakaviatos N, Finnerty FA Jr. Intravenous administration of furosemide in heart failure . JAMA . 1967;200:824-829.Crossref 11. Caranford JH, McDaniel WS. Observation on mercurial diuretics . Ann Intern Med. 1935;8:1266-1273.Crossref 12. Cody RJ, Ljungman S, Covit AB, et al. Regulation of glomerular filtration rate in chronic congestive heart failure patients . Kidney Int. 1988;34:361-367.Crossref 13. Leithe ME, Magorien RD, Hermiller JB, Unverferth DV, Leier CV. Relationship between central hemodynamics and regional blood flow in normal subjects and in patients with congestive heart failure . Circulation . 1984;69:57-64.Crossref 14. Cody RJ. Neurohormonal influences in the pathogenesis of congestive heart failure . In: Weber K, ed. Heart Failure . Philadelphia, Pa: WB Saunders Co; 1989:73-86. 15. Francis GS, Goldsmith SR, Levine TB, Cohn JN. The neurohormonal axis in congestive heart failure . Ann Intern Med. 1984;101:370-377.Crossref 16. Anand IS, Ferrari R, Kalra GS, Wahi PL, Poole-Wilson PA. Edema of cardiac origin: studies of body water and sodium, renal function, hemodynamic indices, and plasma hormones in untreated congestive cardiac failure . Circulation . 1989;80:299-305.Crossref 17. Cody RJ, Atlas SA, Laragh JH, et al. Atrial natriuretic factor in normal subjects and heart failure patients: plasma levels and renal, hormonal and hemodynamic response to peptide infusion . J Clin Invest. 1986;78:1362-1374.Crossref 18. Cody RJ, Torre S, Clark M, Pondolfino K. Age-related hemodynamic, renal, and hormonal differences in patients with congestive heart failure . Arch Intern Med. 1989;149:1023-1028.Crossref 19. Pecker MS. Pathophysiologic effects and strategies for long-term diuretic treatment of hypertension . In: Laragh JH, Brenner BM, eds. Hypertension: Pathophysiology. Diagnosis and Management . New York, NY: Raven Press; 1990:2143-2167. 20. Skott O, Briggs JP. Direct demonstration of macula densa mediated renin secretion . Science . 1987; 237:1618-1620.Crossref 21. Cody RJ, Covit AB, Schaer GL, Laragh JH, Sealey JE, Feldschuh J. Sodium and water balance in chronic congestive heart failure . J Clin Invest. 1986;77:1441-1452.Crossref 22. Wilcox CS, Mitch WE, Kelly RA, et al. Response to furosemide, I: effect of salt intake and renal compensation . J Lab Clin Med. 1983;102:450-458. 23. Ellison D, Velazquez H, Wright FS. Adaptation of the distal convoluted tubule of the rat: structural and functional effects of dietary salt intake and chronic diuretic infusion . J Clin Invest. 1989;83:113-126.Crossref 24. Stanton B, Kaissling B. Adaptation of distal tubule and collecting duct to increased sodium delivery, II: Na+ and K+ transport . Am J Physiol. 1988;255:F1269-F1275. 25. Wilcox CS. Diuretics . In: Brenner BM, Rector FC Jr, eds. The Kidney . 4th ed. Philadelphia, Pa: WB Saunders Co; 1991;2:2133-2147. 26. Grantham JJ, Chonko AM. The physiologic basis and clinical use of diuretics . In: Brenner BM, Stein JH, eds. Contemporary Issues in Nephrology: Sodium and Water Homeostasis . New York, NY: Churchill Livingstone; 1978:178-211. 27. Lal S, Murtagw JG, Pollock AM, Fletcher E, Binnion PF. Acute hemodynamic effects of furosemide in patients with normal and raised left atrial pressures . Br Heart J. 1969;31:711-717.Crossref 28. Dikshit K, Vyden JK, Forrester JS, et al. Renal and extrarenal hemodynamic effects of furosemide in congestive heart failure after myocardial infarction . N Engl J Med. 1973;288:1087-1090.Crossref 29. Magrini F, Niarchos AP. Hemodynamic effects of massive peripheral edema . Am Heart J. 1983; 105:90-94.Crossref 30. Stampfer M, Epstein SE, Beiser DG, Braunwald E. Hemodynamic effects of diuresis at rest and during intense upright exercise in patients with impaired cardiac function . Circulation . 1968;37:900-911.Crossref 31. Francis GS, Siegel RM, Goldsmith SR, Olivari MT, Levine TB, Cohn JN. Acute vasoconstrictor response to intravenous furosemide in patients with chronic congestive heart failure . Ann Intern Med. 1985;103:1-6.Crossref 32. Ikram H, Chan W, Espiner EA, Nicholls MG. Hemodynamic and hormone responses to acute and chronic furosemide therapy in congestive heart failure . Clin Sci. 1980;59:443-449. 33. Kubo SH, Clark M, Laragh JH, Borer JS, Cody RJ. Identification of normal neurohormonal activity in mild congestive heart failure and stimulating effect of upright posture and diuretics . Am J Cardiol. 1987;60:1322-1328.Crossref 34. Bayliss J, Norell M, Canepa-Anson R, Sutton G, Poole-Wilson P. Untreated heart failure: clinical and neuroendocrine effects of introducing diuresis . Br Heart J. 1987;57:17-22.Crossref 35. Lant A. Diuretics: clinical pharmacology and therapeutic use (part 1) . Drugs . 1985;29:57-87.Crossref 36. Lant A. Diuretics: clinical pharmacology and therapeutic use (part 2) . Drugs . 1985;29:162-188.Crossref 37. Cook JA, Smith DE, Cornish LA, Tankanow RM, Nicklas JM, Hyneck ML. Kinetics, dynamics, and bioavailability of bumetanide in healthy subjects and patients with congestive heart failure . Clin Pharmacol Ther. 1988;44:487-500.Crossref 38. Cutter RE, Blair AD. Clinical pharmacokinetics of furosemide . Clin Pharmacokinet 1979;4:279-296.Crossref 39. Ward A, Heel RC. Bumetanide: a review of its pharmacodynamic and pharmacokinetic properties and therapeutic use . Drugs . 1984;28:426-464.Crossref 40. Weiner IM, Mudge GH. Diuretics and other agents employed in the mobilization of edema fluid . In: Goodman LS, Gilman AG, eds. The Pharmacologic Basis of Therapeutics . 7th ed. New York, NY: Macmillan Publishing Co Inc; 1985:887-907. 41. Brater DC. Clinical pharmacology of loop diuretics . Drugs . 1991;42( (suppl 3) ):14-22.Crossref 42. Friedel HA, Buckley MMT. Torsemide: a review of its pharmacological properties and therapeutic potential . Drugs . 1991;41:81-103.Crossref 43. Brater DC, Leinfelder J, Anderson SA. Clinical pharmacology of torsemide, a new loop diuretic . Clin Pharmacol Ther. 1987;42:187-192.Crossref 44. Cuvelier R, Pellegrin P, Lesne M, et al. Site of action of torsemide in man . Eur J Clin Pharmacol. 1986;31( (suppl) ):15-19.Crossref 45. Brater DC, Pressley RH, Anderson SA. Mechanism of the synergistic combination of metolazone and bumetanide . J Pharmacol Exp Ther. 1985;233:70-74. 46. Wollam GL, Tarazi RC, Bravo EL, Dustan HP. Diuretic potency of combined hydrochlorothiazide and furosemide therapy in patients with azotemia . Am J Med. 1982;72:929-938.Crossref 47. Oster JR, Epstein M, Smoller S. Combined therapy with thiazide-type and loop diuretic agents for resistant sodium retention . Ann Intern Med. 1983; 99:405-406.Crossref 48. Brater DC, Seiwell R, Anderson S. Absorption and disposition of furosemide in congestive heart failure . Kidney Int. 1982;22:171-176.Crossref 49. Brater DC, Day B, Burdette A, Anderson S. Bumetanide and furosemide in heart failure . Kidney Int. 1984;26:183-189.Crossref 50. Cook JA, Smith DE, Cornish LA, et al. Kinetics, dynamics, and bioavailability of bumetanide in healthy subjects and patients with congestive heart failure . Clin Pharmacol Ther. 1988;44:487-500.Crossref 51. Brater DC. Resistance to loop diuretics: why it happens and what to do about it . Drugs . 1985; 30:427-443.Crossref 52. Brater DC. Disposition and response to bumetanide and furosemide . Am J Cardiol. 1986; 57:20A-25A.Crossref 53. Ellison DH. The physiologic basis of diuretic synergism: its role in treating diuretic resistance . Ann Intern Med. 1991;114:886-894.Crossref 54. Vasko MR, Brown-Cartwright D, Knochel JP, et al. Furosemide absorption altered in decompensated congestive heart failure . Ann Intern Med. 1985;102:314-318.Crossref 55. Brater DC, Chennavasin P, Seiwell R. Furosemide in patients with heart failure: shift in dose-response curves . Clin Pharmacol Ther. 1980;28:182-186.Crossref 56. Beerman B, Groschinsky-Grind M. Pharmacokinetics of hydrochlorothiazide in patients with congestive heart failure . Br J Clin Pharmacol. 1979; 7:579-583.Crossref 57. Dyckner T, Wester PO. Plasma and skeletal muscle electrolytes in patients on long-term diuretic therapy for arterial hypertension and/or congestive heart failure . Acta Med Scand. 1987;222:231-236.Crossref 58. Holmes J, Kubo SH, Cody RJ, Kligfield P. Arrhythmias in ischemic and nonischemic dilated cardiomyopathy: prediction of mortality by ambulatory electrocardiography . Am J Cardiol. 1985;55:146-151.Crossref 59. Gradman A, Deedwania P, Cody R, et al. Predictors of total mortality and sudden death in mild to moderate heart failure . J Am Coll Cardiol. 1989;14:564-570.Crossref 60. Hlatky MA, Fleg JL, Hinton PC, et al. Physician practice in the management of congestive heart failure . J Am Coll Cardiol. 1986;8:966-970.Crossref 61. Pfeffer MA, Braunwald E, Moye LA, et al. Effects of captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction . N Engl J Med. 1992;327:669-677.Crossref 62. The SOLVD Investigators. Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions . N Engl J Med. 1992; 327:685-691.Crossref 63. Odemuyiwa O, Gilmartin J, Kenny D, Hall RJC. Captopril and the diuretic requirements in moderate and severe chronic heart failure . Eur Heart J. 1989;10:586-590. 64. Anand IS, Kalra GS, Ferrari R, Wahi PL, Harris PC, Poole-Wilson PA. Enalapril as initial and sole treatment in severe chronic heart failure with sodium retention . Int J Cardiol. 1990;28:341-346.Crossref 65. Richardson A, Bayliss J, Scriven AJ, Parameshwar J, Poole-Wilson PA, Sutton GC. Double blind comparison of captopril alone against furosemide plus amiloride in mild heart failure . Lancet . 1987;2: 709-711.Crossref 66. Ikram H, Webster MWI, Nicholls MG, Lewis GRJ, Richards AM, Crozier IG. Combined spironolactone and converting-enzyme inhibitor therapy for refractory heart failure . Aust N Z J Med. 1986;16:61-63.Crossref 67. Cody RJ. Clinical trials of diuretic therapy in congestive heart failure: research needs and clinical considerations . J Am Coll Cardiol. 1993;21 ( (suppl A) ):165A-171A.Crossref 68. Cody RJ. The need for a sodium retention score in clinical trials of heart failure . Clin Pharmacol Ther. 1993;54:7-10.Crossref 69. Channavasin P, Seiwell R, Brater DC. 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Journal

Archives of Internal MedicineAmerican Medical Association

Published: Sep 12, 1994

References