Risler T, Braun N, Erley C
Sektion Nieren- und Hochdruckkrankheiten, Medizinischen Universitätsklinik Tübingen.
Wien Med Wochenschr. 1996;146(16):447-50.
Basically the cause of the resistance to diuretics can be found out. Essential is a detailed knowledge of the physiology and pathophysiology of volume regulation as well as renal water and electrolyte excretion. To get diagnostic and therapeutic access to diuretic resistance main efforts have to be put into the work up of current diagnostics and therapy of the main disease (heart failure, liver failure, nephrotic syndrome, and renal failure) as well as the symptomatic, drug related volume regulation (exact balancing of fluid intake and excretion with and without diuretics) in these severely ill patients. Has the underlying cause for resistance to diuretic medication been found, therapy is generally easy and effective. It might be unsuccessful in patients with severe impairment of renal function. Then the only way may be extracorporeal fluid removal.
基本上，可以找出对利尿剂产生抵抗的原因。关键是要详细了解容量调节以及肾脏水和电解质排泄的生理学和病理生理学。为了对利尿剂抵抗进行诊断和治疗，必须主要致力于对主要疾病（心力衰竭、肝功能衰竭、肾病综合征和肾衰竭）的当前诊断和治疗以及这些重症患者中与药物相关的症状性容量调节（精确平衡使用和不使用利尿剂时的液体摄入和排泄）进行检查。如果找到了对利尿药物产生抵抗的根本原因，治疗通常简单有效。对于肾功能严重受损的患者，治疗可能不成功。那么唯一的办法可能是进行体外液体清除。
