Refractory Edema with Congestive Heart Failure Stepwise Approaches Nephrology Perspectives

Abstract

Generalized edema occurs secondary to many clinical disorders; the usual management of edema is the using of diuretics. Diuretic resistance means failure to decrease the extracellular fluid volume despite the using of diuretics. Many factors are involved in the development of refractory edema, and the decreased response to the usual diuretic regimen, during management of diuretic resistance all these factors must be in consideration. Some pre-diuresis precautions, lab and imaging procedures are mandatory to ensure good effect of management. To use intermittent Intravenous Bolus versus Continuous IV Infusion Diuretic Therapy, which is better, which is safest? What is Single IV Effective Dose of Loop Diuretics What is Maximum IV Effective Dose of Loop Diuretics? If IV Furosemide is Ineffective, Can I Switch to Equivalent IV Dose of Bumetanide or Torsemide? When to Add Thiazide Diuretic? When to Add Spironolactone? IV High-Dose Furosemide and Hypertonic Saline Solutions, The new ERA. How to Monitor Response and Side Effects of IV Diuretic Therapy? All these questions are answered in the review article.