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Glucocorticoids in Diuretic Resistance: An Emerging Approach for Heart Failure
Dorian Bolanos1, Jackeline Flores, Camilo Pena
1From the Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX.
Cardiology in Review
|August 20, 2025
Summary
Diuretic resistance in heart failure (HF) poses a major challenge. Glucocorticoids show potential as an adjunctive therapy to improve diuretic efficacy and renal function in HF patients.
Area of Science:
- Cardiology
- Nephrology
- Pharmacology
Background:
- Diuretic resistance is a significant clinical challenge in heart failure (HF) management.
- It leads to recurrent hospitalizations and adverse patient outcomes.
- HF prevalence is projected to increase significantly in the coming years.
Purpose of the Study:
- To define diuretic resistance in the context of HF.
- To explore the pathogenesis of diuretic resistance.
- To review the potential role of glucocorticoids as adjunctive therapy for diuretic resistance.
Main Methods:
- This study is a narrative review.
- Literature search on diuretic resistance, HF, and glucocorticoids.
- Analysis of existing research on glucocorticoid effects on diuretic response and renal function.
Main Results:
- Diuretic resistance is multifactorial, involving pharmacokinetic changes, hormonal imbalances, and cardiorenal syndrome (CRS).
- Glucocorticoids (e.g., dexamethasone, prednisone) have demonstrated potential to enhance diuretic effects and improve renal function.
- These effects are attributed to their systemic and cardiovascular actions.
Conclusions:
- Diuretic resistance significantly impacts HF patient outcomes.
- Glucocorticoids represent a potential adjunctive treatment strategy.
- Further research is crucial to establish the efficacy and safety of glucocorticoids in managing diuretic resistance in HF.
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