But just work, I have encountered such a patient: Although the application of adequate diuretics, still did not reduce edema, when I was dumbfounded.
Diuretics resistance
Clinical work for a long time, often encounter this thing, this situation is called "diuretic resistance", that is, diuretics can not eliminate the situation of edema.
I think, since the intravenous use of loop diuretics ineffective, then diuretic synergistic effect, plus thiazide diuretic drugs chlorthalidone.
The result is so disappointed.
This combination therapy still did not lose weight.
At that time is the pattern, the young I did not have much to deal with. At that time my teacher is a highly respected professor, both do clinical, but also to do teaching, but the temper is not very good. I can share with him different views, he will guide me direction, but asked him the basis of the problem is to curse. Besides, the familiarity with the patient is not as good as me.
Treatment for Hypotension During Dialysis
Patients with hepatitis C, is a membranoproliferative nephritis patients.
So finally I analyzed the information and his condition, he was given with rituximab, combined with diuretics and B cell depletion treatment.
Creatinine Level Is Still 1933 With Dialysis 4 Times A Week
This time finally effective!
Patients with edema subsided, weight loss, renal function has also been improved.
Recommendations for edema patients
Despite the use of sufficient diuretics, still do not achieve the required treatment to reduce the swelling, you can follow the "diuretic resistance" treatment.
Combined with two diuretics applications, often can improve diuretic resistance;
Epithelial sodium channel blockers, but also candidates that can be considered;
Edema is difficult to eliminate the common causes, as well as diet, medication is not standardized and so on these "human factors." Hope that both the doctor or the patient, are serious about the disease.
