DIURETIC RESISTANCE IN PATIENTS PRESENTING WITH HEART FAILURE TO CARDIOLOGY DEPARTMENT OF A TEACHING HOSPITAL
Keywords:
Diuretic Resistance, Heart Failure, FrequencyAbstract
Objective: To determine the frequency and outcome of Diuretic Resistance (DR) in patient with heart failure admitted
in the Cardiology Department of a Tertiary Care Hospital.
Material and Methods: This observational study was conducted at Cardiology Department, Khyber Teaching Hospital,
Peshawar, Pakistan from January 2014 to December 2014. Adult patients admitted with diagnosis of heart failure during
this duration were five hundred and sixty. Patients discharged within 24 hours (n=152 )and/or having incomplete information
(n=113), were excluded from our study, the remaining Two hundred and ninety five were included in the study.
Patients received I/V furosemide dose of 160 mg per day was considered as cut of value between diuretic responders
[using < 160 mg furosemide per day (group I)] and diuretic resistant [using ? 160 mg furosemide per day (group II)].
Results: Out of two hundred and ninty five patients, 175(59.33%) were male and 120(40.67%) were female. Mean age of
study population was 65±7 years. Patients responding to diuretics (group-I) were 190 (64.1%), while patients resistant
to diuretics (group-II) were 105 (35.9%). Among group-I male were 114 (60%) and female were 76 (40%) while among
group-II male were 61 (58%) and female were 44 (42%). Patient with DR (group II) were having significantly higher CAD
and diabetes as compared to group I. Patients in group II were significantly more anemic, hypokalemic, hyponatremicand
were having higher creatinine and cholesterol level as compared to group I. Blood pressure was lower in group
II but raised JVP and edema were more common in group I. Total duration of hospital stay is >3 days in DR group.
Conclusion: Diuretic resistance is a common problem in patients presenting with uncontrolled comorbidies in heart failure
patients. Early recognition of this problem and prompt aggressive treatment may help shorter stay of hospitalization.
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