Search results for "diuretic"

Management of Blood Pressure and Heart Rate in Patients with Acute Stroke

2017

BACKGROUND: Stroke represent one of the most devastating of all neurological diseases, affecting about 15 million people per year and is an important cause of morbidity and mortality worldwide and currently the leading cause of adult disability in developed countries. Blood pressure and heart rate may undergo several modifications in patients with both ischemic and hemorrhagic stroke in fact raised blood pressure levels may lead to cerebral edema, hematoma expansion or hemorrhagic transformation and in contrast low blood pressure can lead to increased cerebral infarction or perihematomal ischemia. In addition, ECG abnormalities and cardiac arrhythmias, especially atrial fibrillation, are re…

Blood Pressure Measurement Before and After Intervention

2016

The complexity and the uncertainties about long-term effect of the invasive interventions to treat essential hypertension (HTN) require a precise diagnosis about the real “resistance” to the antihypertensive treatment given, and it is defined when a therapeutic strategy that includes appropriate lifestyle measures plus a diuretic and two other antihypertensive drugs belonging to different classes at adequate doses fails to lower systolic blood pressure (SBP) and diastolic blood pressure (DBP) values to <140 and 90 mmHg, respectively. Consequently, in the process of diagnosis and follow-up, blood pressure (BP) measurement is the first step that is not exempt of difficulties due to the variab…

Special Considerations for Antihypertensive Agents in Dialysis Patients

2010

Hypertension is present in most patients with end-stage renal disease and likely contributes to the premature cardiovascular disease in dialysis patients. Previous practice guidelines have recommended that, in patients on chronic dialysis, blood pressure (BP) should be reduced below 130/80 mm Hg. This is based on opinions but not strong evidence, since no concrete information exists about which BP values should be the parameter to follow and which should be the target BP values. The majority of the antihypertensive agents can be used in this population, but the pharmacokinetics altered by the impaired kidney function and dialyzability influence the appropriate dosage as well as the time and…

Inappropriate Antidiuretic Hormone Secretion in Pulmonary Nocardiosis

2006

Fetal Renal Effects of Intrauterine Diuretic Application in Wistar Rats

1987

The application of placenta-permeable diuretics in the pregnant woman has been the subject of controversial discussion (Friedberg 1980; Souster and Emery 1980). Not only is the fetus endangered by potential placental ischaemia, natrium and potassium loss and possible dehydration in the mother (Friedberg 1980; Gant and Madden 1975), but also induced effects on fetal organ formation should be considered (Frohneberg and Hutschenreiter 1982; Seufert 1986). Depending on the site of action and placental permeability, fetal urine production can be increased (Wladimiroff 1975), thus leading to consequences for the morphological and functional embryogenesis of isolated nephron sections (Frohneberg 1…

Nephrotoxic drug burden among 1001 critically ill patients: impact on acute kidney injury.

2019

Abstract Background Nephrotoxic drug prescription may contribute to acute kidney injury (AKI) occurrence and worsening among critically ill patients and thus to associated morbidity and mortality. The objectives of this study were to describe nephrotoxic drug prescription in a large intensive-care unit cohort and, through a case–control study nested in the prospective cohort, to evaluate the link of nephrotoxic prescription burden with AKI. Results Six hundred and seventeen patients (62%) received at least one nephrotoxic drug, among which 303 (30%) received two or more. AKI was observed in 609 patients (61%). A total of 351 patients were considered as cases developing or worsening AKI a gi…

Physiopathological, Epidemiological, Clinical and Therapeutic Aspects of Exercise-Associated Hyponatremia.

2014

Exercise-associated hyponatremia (EAH) is dilutional hyponatremia, a variant of inappropriate antidiuretic hormone secretion (SIADH), characterized by a plasma concentration of sodium lower than 135 mEq/L. The prevalence of EAH is common in endurance (&lt;6 hours) and ultra-endurance events (&gt;6 hours in duration), in which both athletes and medical providers need to be aware of risk factors, symptom presentation, and management. The development of EAH is a combination of excessive water intake, inadequate suppression of the secretion of the antidiuretic hormone (ADH) (due to non osmotic stimuli), long race duration, and very high or very low ambient temperatures. Additional risk factors …

Early urinary sodium trajectory and risk of adverse outcomes in acute heart failure and renal dysfunction.

2021

Introduction and objectives: Urinary sodium (UNa+) has emerged as a useful biomarker of poor clinical outcomes in acute heart failure (AHF). Here, we sought to evaluate: a) the usefulness of a single early determination of UNa+ for predicting adverse outcomes in patients with AHF and renal dysfunction, and b) whether the change in UNa+ at 24 hours (Delta UNa24 h) adds any additional prognostic information over baseline values. Methods: This is a post-hoc analysis of a multicenter, open-label, randomized clinical trial (IMPROVE-HF) (ClinicalTrials.gov NCT02643147) that randomized 160 patients with AHF and renal dysfunction on admission to a) the standard diuretic strategy, or b) a carbohydra…

Effects of intravenous furosemide plus small-volume hypertonic saline solutions on markers of heart failure.

2021

Aims: We sought to compare the effects of furosemide + hypertonic saline solution (HSS) treatment in patients with acute decompensated heart failure in comparison with furosemide alone and the response in a compensated state after an acute saline load with regard to serum levels of heart failure biomarkers. Methods and results: We enrolled 141 patients with acute decompensated heart failure with reduced ejection fraction admitted to our Internal Medicine ward from March 2017 to November 2019. A total of 73 patients were randomized to treatment with i.v. high-dose furosemide plus HSS, whereas 68 patients were randomized to i.v. high-dose furosemide alone. Patients treated with furosemide plu…

Impact of chronic diuretic treatment on glucose homeostasis

2013

Background The use of diuretics for hypertension has been associated with unfavorable changes in cardiovascular risk factors, such as uric acid and glucose tolerance, though the findings in the literature are contradictory. Methods This study investigated whether diuretic use is associated with markers of metabolic and cardiovascular risk, such as insulin-resistance and uric acid, in a cohort of adults without known diabetes and/or atherosclerotic cardiovascular disease. Nine hundred sixty-nine randomly selected participants answered a questionnaire on clinical history and dietary habits. Laboratory blood measurements were obtained in 507 participants. Results Previously undiagnosed type 2 …