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Eric Bonnefoy-cudraz - One of the best experts on this subject based on the ideXlab platform.

  • Patients with acute heart failure treated with the CARRESS-HF diuretic protocol in association with Canrenoate Potassium: Tolerance of high doses of Canrenoate Potassium.
    Archives of cardiovascular diseases, 2020
    Co-Authors: Clothilde Berger, C. Prieur, Thomas Bochaton, Julien Berthiller, Charles-edouard Luyt, Eric Bonnefoy-cudraz
    Abstract:

    Summary Background Oral mineralocorticoid receptor antagonists have failed to prove their efficacy for decongestion and Potassium homeostasis in acute heart failure. Intravenous mineralocorticoid receptor antagonists have yet to be studied. Aim The aim of this study was to confirm the safety of high-dose Potassium Canrenoate in association with classic diuretics in acute heart failure. Methods This retrospective single-centre study included consecutive patients who were hospitalized with acute heart failure between 2013 and 2018. One hundred patients with overload treated with the standardized diuretic protocol from the CARRESS-HF trial were included. There were no exclusion criteria relating to creatinine or kalaemia at the time of admission. Two groups were constituted on the basis of Potassium Canrenoate posology: a low-dose group ( Results Mean daily Potassium Canrenoate doses were 198 mg/day (range 100–280 mg/day) in the low-dose group and 360 mg/day (range 300–600 mg/day) in the high-dose group. There was no significant difference between the high-dose and low-dose groups in terms of mortality, dialysis, renal function, hyperkalaemia, haemorrhage, sepsis or confusion. Conclusions Potassium Canrenoate at high doses can be used safely in association with standard diuretics in acute heart failure, even in patients with altered renal function. A prospective study is required to evaluate the efficacy of high-dose Potassium Canrenoate in preventing hypokalaemia and improving decongestion.

S Condò - One of the best experts on this subject based on the ideXlab platform.

  • Diuretic therapy in heart failure
    Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia, 2006
    Co-Authors: G Splendiani, S Condò
    Abstract:

    Diuretic therapy is a drug therapy that increases urine volume, but not glomerular filtration rate (GFR). The diuretics act predominantly on tubular sites; the drugs that increase GRF are the aminophyllines, the positive inotropy or vasoactive substances that increase afferent arteriolar flux or intraglomerular pressure. We can divide the diuretics into six categories: 1) carbonic anhydrase inhibitors: acetazolamide, dichlorphenamide, methazolamide; 2) osmotic diuretics: glycerol, mannitol, urea; 3) loop diuretics: furosemide, bumetanide, ethacrynic acid, piretanide, torsemide; 4) thiazide and thiazide-like diuretics: chlorothiazide, trichlormethiazide, indapamide, chlorthalidone, metolazone; 5) Potassium-sparers: a) kidney epithelial sodium channel inhibitors: amiloride and triamterene; b) aldosterone receptor antagonists: spironolactone, Canrenoate Potassium, eplerenone; 6) ADH antagonists: lithium salts, demeclocycline and ethanol. Diuretic therapy is useful in treating acute and chronic renal insufficiency, congestive heart failure, cirrhosis, overhydration and hypertension. Diuretic therapy increases urine volume, ion loss (except Na+, K+), and modifies diffusion (dilute urine) and convection mechanisms (reduced tubular absorption). Therefore, diuretics are very useful non-dangerous drugs.

Clothilde Berger - One of the best experts on this subject based on the ideXlab platform.

  • Patients with acute heart failure treated with the CARRESS-HF diuretic protocol in association with Canrenoate Potassium: Tolerance of high doses of Canrenoate Potassium.
    Archives of cardiovascular diseases, 2020
    Co-Authors: Clothilde Berger, C. Prieur, Thomas Bochaton, Julien Berthiller, Charles-edouard Luyt, Eric Bonnefoy-cudraz
    Abstract:

    Summary Background Oral mineralocorticoid receptor antagonists have failed to prove their efficacy for decongestion and Potassium homeostasis in acute heart failure. Intravenous mineralocorticoid receptor antagonists have yet to be studied. Aim The aim of this study was to confirm the safety of high-dose Potassium Canrenoate in association with classic diuretics in acute heart failure. Methods This retrospective single-centre study included consecutive patients who were hospitalized with acute heart failure between 2013 and 2018. One hundred patients with overload treated with the standardized diuretic protocol from the CARRESS-HF trial were included. There were no exclusion criteria relating to creatinine or kalaemia at the time of admission. Two groups were constituted on the basis of Potassium Canrenoate posology: a low-dose group ( Results Mean daily Potassium Canrenoate doses were 198 mg/day (range 100–280 mg/day) in the low-dose group and 360 mg/day (range 300–600 mg/day) in the high-dose group. There was no significant difference between the high-dose and low-dose groups in terms of mortality, dialysis, renal function, hyperkalaemia, haemorrhage, sepsis or confusion. Conclusions Potassium Canrenoate at high doses can be used safely in association with standard diuretics in acute heart failure, even in patients with altered renal function. A prospective study is required to evaluate the efficacy of high-dose Potassium Canrenoate in preventing hypokalaemia and improving decongestion.

G Splendiani - One of the best experts on this subject based on the ideXlab platform.

  • Diuretic therapy in heart failure
    Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia, 2006
    Co-Authors: G Splendiani, S Condò
    Abstract:

    Diuretic therapy is a drug therapy that increases urine volume, but not glomerular filtration rate (GFR). The diuretics act predominantly on tubular sites; the drugs that increase GRF are the aminophyllines, the positive inotropy or vasoactive substances that increase afferent arteriolar flux or intraglomerular pressure. We can divide the diuretics into six categories: 1) carbonic anhydrase inhibitors: acetazolamide, dichlorphenamide, methazolamide; 2) osmotic diuretics: glycerol, mannitol, urea; 3) loop diuretics: furosemide, bumetanide, ethacrynic acid, piretanide, torsemide; 4) thiazide and thiazide-like diuretics: chlorothiazide, trichlormethiazide, indapamide, chlorthalidone, metolazone; 5) Potassium-sparers: a) kidney epithelial sodium channel inhibitors: amiloride and triamterene; b) aldosterone receptor antagonists: spironolactone, Canrenoate Potassium, eplerenone; 6) ADH antagonists: lithium salts, demeclocycline and ethanol. Diuretic therapy is useful in treating acute and chronic renal insufficiency, congestive heart failure, cirrhosis, overhydration and hypertension. Diuretic therapy increases urine volume, ion loss (except Na+, K+), and modifies diffusion (dilute urine) and convection mechanisms (reduced tubular absorption). Therefore, diuretics are very useful non-dangerous drugs.

Nobuhisa Hagiwara - One of the best experts on this subject based on the ideXlab platform.

  • Randomized pilot trial comparing tolvaptan with furosemide on renal and neurohumoral effects in acute heart failure.
    ESC heart failure, 2016
    Co-Authors: Kentaro Jujo, Katsumi Saito, Issei Ishida, Yuho Furuki, Ahsung Kim, Yuki Suzuki, Haruki Sekiguchi, Junichi Yamaguchi, Hiroshi Ogawa, Nobuhisa Hagiwara
    Abstract:

    Aims Loop diuretics are first-line medications for congestive heart failure (CHF); however, they are associated with serious adverse effects, including decreased renal function, and sympathetic nervous and renin–angiotensin system activation. We tested whether tolvaptan, a vasopressin V2-receptor antagonist, could reduce unfavourable furosemide-induced effects during CHF treatment. Methods and results Sixty patients emergently hospitalized owing to CHF-induced dyspnea were randomly assigned to receive either 40 mg intravenous furosemide daily or 7.5 mg oral tolvaptan for 5 days after admission. Both groups also received intravenous carperitide and Canrenoate Potassium. As results, baseline patient characteristics were similar between the furosemide (n = 30) and the tolvaptan (n = 30) groups, with no significant difference in 5 day urine volume or fluid balance. Brain natriuretic peptide and body weight improvements were similar between groups. However, serum creatinine (Cr) level did not increase, and the incidence of worsening renal function was significantly lower in the tolvaptan group. Consequently, the Cr increase to gain 1000 mL urine was 2.5-fold lower in the tolvaptan group. Furthermore, the blood urea nitrogen (BUN)/Cr ratio significantly decreased in the tolvaptan group, suggesting that renal perfusion was preserved, and urea reuptake and passive water reabsorption were suppressed following tolvaptan treatment. Although catecholamine improvements after treatment were not significantly different, plasma renin activity was enhanced in the furosemide group. Conclusions As compared with furosemide, tolvaptan in patients with acute heart failure is associated with comparable decongestion, better preservation of renal function and less activation of renin–angiotensin system. (UMIN 000014134).