Resistencia diurética e insuficiencia cardiaca: entre la congestión y la disfunción renal

Autores/as

  • Paola Morejón-Barragán Instituto Argentino de Diagnóstico y Tratamiento, Buenos Aires, Argentina

DOI:

https://doi.org/10.47487/apcyccv.v1i3.72

Palabras clave:

insuficiencia cardiaca, diuréticos, síndrome cardiorenal, resistencia a los diuréticos, congestión

Resumen

La Insuficiencia Cardiaca (IC), uno de los principales contribuyentes de la mortalidad cardiovascular en la actualidad, nos enfrenta a grandes retos. La interacción riñón corazón tiene particular atención por el desarrollo del denominado síndrome cardiorenal (SCR) y con este, la resistencia a los diuréticos (RD), predictor de eventos adversos en IC aguda independiente de la tasa de filtrado glomerular (TFG). Su desarrollo es secundario a múltiples causas, por lo que se requiere una evaluación integral de todas ellos. En los últimos años ha tomado relevancia la congestión dentro del mecanismo fisiopatológico del SCR, por generar y perpetuar mutuamente el daño en estos dos órganos. Ante la importancia de la congestión, los diuréticos se mantienen como clave para el tratamiento, aunque su empleo ampliamente es empírico por la escasa evidencia disponible. El paradigma del tratamiento basado en evidencia, es esquivo en este escenario, por lo que una pregunta permanece sin respuesta ¿intervenciones para tratar la RD o para prevenirla modifican el pronóstico en IC aguda?

 

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16-09-2020

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