[Effect of loop diuretics with different elimination half-lives on natriuresis changes and indicators characterizing...

To investigate the effect of loop diuretics with different elimination half-lives on natriuresis (NU) changes in patients with hypertensive disease (HD) and chronic heart failure (CHF).

Fifty-six patients who had signs of progressive CHF and needed diuretic therapy were selected from a group of the patients who had participated in our previous study of the types of natriuretic curves. They all received torasemide SR or torasemide IR.

It has been shown that the type of a natriuretic curve may be variable in the patients. In the toracemide IR group, NU worsens more frequently and earlier than in the toracemide SR group (p < 0.05). The type of the curve is associated with elevated Tamm-Horsfall protein (THP) levels, its transition from one to another type, and the duration of HD to the greatest degree. It has been found that the longer history of HD is, the higher effect of angiotensin II is. The probability of transition of the natriuretic curve from type 3 to 2 is 83.93% (odds ratio 11.667) from type 2 to 1 is 92.86% (odds ratio 120.00).

With time and altered NU, there is a significant deterioration of sodium excretion, and an increase in THP excretion, which is a marker for progressive tubulointerstitial fibrosis, and angiotensin II activity increases, which gives proof to the necessity of monitoring NU.