Volume management in organs failure Role of Diuretics

Volume management in organs failure ( Role of Diuretics)

OUTLINE 1 -Diuretics: General considerations (Dr. Hakemi) 2 -Diuretics administration & withdrawal in CHF 3 -Use of Diuretics in patients with cirrhosis 4 -Diuretics for treatment of edema in Nephrotic syndrome 5 -Principles of Diuretics therapy in CKD 6 -Volume management in Dialysis patients

OUTLINE-1 1 -Diuretics: General considerations 2 -Diuretics administration & withdrawal in CHF 3 -Use of Diuretics in patients with cirrhosis 4 -Diuretics for treatment of edema in Nephrotic syndrome 5 -Principles of Diuretics therapy in CKD 6 -Volume management in Dialysis patients

OUTLINE-2 1 - Edema mechanisms 2 - Role of kidney in volume regulation 3 - Organ cross talk 4 - Diuretics 5 - Diuretic resistance 6 - Principles of diuretic prescription in different diseases

v Fluid moves from plasma to interestitium

Mechanism of Generalized Edema 1 - Increased capillary hydrostatic pressure a-increased plasma volume due to renal sodium retention b-venous obs or insufficiency c-arteriolar vasodilation 2 - Hypoalbuminemia a-protein loss b-reduced protein synthesis 3 - Increased capillary permeability 4 - Lymphatic obs or increased interstitial oncotic pressure

Regulation of water and sodium excretion

ECF volume regulation by kidney 1 - Reabsorption of Na and H 20@ renal tubules which depends on filtration fraction and starling forces 2 - Reabsorption of H 2 O@collecting tubule which depends on plasma osmolality

kidney Na intake Na excretion Water excretion

ORGANS CROSS TALK

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How to prescribe Diuretics in different diseases ? ? ?