2023年1月11日 · Diuretics remain as one of our most powerful tools in the management of fluid overload in different clinical settings. The development of diuretic braking leading to resistance represents a major hindrance in the management of the congested and oliguric patient.

2020年8月24日 · Diuretic braking phenomenon and diuretic resistance. Schematic representation of a diuretic responsive (gray lines and gray boxes) or resistant subject (dark lines and solid boxes), showing body weight (A) and daily sodium excretion (B) …

Diuretic resistance is a failure to increase fluid and sodium (Na +) output sufficiently to relieve volume overload, edema or congestion despite a full dose of a loop diuretic.

Diuretic resistance (DR) occurs along a spectrum of relative severity and contributes to worsening of acute heart failure (AHF) during an inpatient stay. This review gives an overview of mechanisms of DR with a focus on loop diuretics and summarizes ...

Diuretic resistance should be differentiated from diuretics’ “braking phenomenon”, which is a normal physiological response to the repetitive dosing of loop diuretics to avoid a drastic volume depletion .

Diuretic adaptations can be classified as those that occur during diuretic action, those that cause sodium retention in the short term (causing 'post-diuretic NaCl retention'), and those that increase sodium retention chronically (the 'braking phenomenon').

Preventing and managing diuretic resistance in CRS requires a multidisciplinary approach that entails restricting dietary salt intake, optimizing dose and frequency of loop diuretic administration, recognizing nephron remodeling and the braking phenomenon, and adding additional classes of …

Unlike the umbrella term diuretic braking, an anatomically based categorization of diuretic resistance mechanisms facilitates recognition of common mechanisms and may ultimately aid clinicians in choosing therapeutic strategies to overcoming resistance.

The third mechanism is "diuretic braking," the decrease in a patient's response to a diuretic after receiving the first dose. In other words, the magnitude of response to each administered dose...

By eliciting significant counter-regulatory responses during acute and chronic use, several effects such as the “braking phenomenon,” post-diuretic effect, rebound sodium retention, and renal adaptation lead to diuretic resistance.