What to do about furosemide resistance

Furosemide resistance requires further management options based on the cause of the resistance. Furosemide is one of the more powerful diuretics, but it is susceptible to resistance when used frequently over a long period of time. Resistance also occurs when the primary disease is not well controlled, and the cause needs to be determined first. Cardiac function, liver and kidney function tests should be done first to determine the cause of edema. Decreased diuretic effect due to frequent use of furosemide can be improved by increasing the dosage if the dosage itself is relatively small. The diuretic effect can also be improved by replacing it with torasemide or a diuretic combination. Oedema is not severe and diuretics can be suspended to restore drug sensitivity in the kidneys. In liver disease, because of decreased diuretic effect due to hypoproteinemia, albumin or fresh plasma can be supplemented to correct the hypoproteinemia before diuretics such as furosemide are used. Uremia due to decreased diuretic effect, need to consider dialysis and other methods of eliminating excess water in the body. Once edema with furosemide effect is not good, more suggestive of the seriousness of the disease, should be timely to the hospital.