慢性肾脏病患者疾病管理ppt课件.pptVIP

Diuretic Tolerance Type I: Short-term Decrease in the response to a diuretic after the first dose Teleologically-- appropriate response to volume depletion Type II: Long-term Hypertrophy of distal nephron segments allowing greater sodium resorption Algorithm for Diuretic Use Renal Insufficiency CrCl 50 Loop Diuretic Determine Effective Dose: 5-10X Usual Dose Administer as Frequently as Necessary Thiazide According to CrCl 20ml/min 20-50 50ml/min 50-100mg/ 50-100mg/ 25-50mg/ day day day ADD Add Distal Diuretic D