Diuretic therapy in heart and kidney diseases – where are we going wrong?

Diuretics are the drugs of choice in hypervolemia, given that their main effect is increased elimination of salt and water from the body. Application of diuretics brings with it many challenges and dilemmas, especially when it comes to patients with heart and kidney diseases. In order to avoid mistakes in the treatment of this population, an understanding of the local and systemic effects of the diuretic itself in conditions of altered adaptive mechanisms of the diseased heart and kidneys is necessary. In daily clinical practice, it is necessary to clearly specify the goals of treatment with diuretics, to evaluate the effectiveness of their application, to solve the problems of diuretic resistance and to use the advantages of diuretic synergism