The appropriate use of diuretics in individuals with acute heart failure remains challenging, especially when worsening renal function, diuretic resistance and electrolyte disturbances occur. This paper focuses on the use of diuretics in heart failure with congestion. This manuscript explores topics, such as evaluation of congestion and clinical euvolaemia, assessment of diuretic response/resistance in the treatment of acute heart failure, an approach towards stepped pharmacologic diuretic strategies, and management of common electrolyte disturbances.
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