Features Of Patients Admitted With Heart Failure And Having Diuretic Resistance

• ORIGINAL ARTICLE | ISSUE DETAILS: VOL NO.2 | ISSUE NO. 2

Abstract

Objective: The current study aimed to identify the features of diuretic resistance (DR) in patients with heart failure who were hospitalized in a tertiary care hospital’s cardiology department.

Materials & Methods: Between January 1, 2014, and December 31, 2014, retrospective observational research was carried out in the Khyber Teaching Hospital cardiology department in Peshawar. There were 560 adult patients diagnosed with heart failure who were hospitalized within a year. Excluded patients were 152 who were released in less than 24 hours and 113 whose full data was not accessible. Thus, the research comprised the remaining patients (560-152-113= 295) whose records were examined. A cutoff point of 160 mg of furosemide per day was established for patients I/V, who were classified as diuretic responders (using < 160 mg/day; group I) and diuretic resistant (using > 160 mg/day; group II).

Results: There were 295 patients, of whom 175 (59.32%) were male and 120 (40.67%) were female. The patients’ average age was 65+7 years. Group I consisted of 190 patients (64.4%) who responded to diuretics, whereas group II consisted of 105 patients (35.9%) who were resistant to diuretics. In group I, there were 114 (60%) males and 76 (40%) females; in group II, there were 61 (58%) males and 44 (41%) females. Clinical and laboratory parameters, comorbidities, and the kind of therapy each group got were compared. Compared to group I, patients with DR (group II) had noticeably greater rates of CAD, diabetes, and asthma. DR patients (Group II) had lower heart rates and blood pressure systolic and diastolic than those in Group I. However, group I had a higher JVP and more noticeable edema in the foot. Compared to group I, patients with DR (group II) had higher rates of anemia, hypokalemic, and hyponatremic conditions. In addition, their creatinine, glucose, and cholesterol levels were higher than those of group I. Those with DR (Group II) used B Blockers, spironolactone, and inotropes at much greater rates than those in Group I.

Conclusion: Patients with heart failure often struggle with diuretic resistance. Patients with DR have substantially distinct characteristics from those who react well to diuretics. When such patients are identified early on, doctors can adopt more aggressive treatment plans, which promotes quicker healing and shorter hospital stays.