Potent Potentiating Diuretic Effects of Prednisone in Congestive Heart Failure

  title={Potent Potentiating Diuretic Effects of Prednisone in Congestive Heart Failure},
  author={Chao Liu and Hua Chen and Caixia Zhou and Zhen-guo Ji and Gang Liu and Yanqiu Gao and L. Tian and L. Yao and Ye Zheng and Qingzhen Zhao and Kunshen Liu},
  journal={Journal of Cardiovascular Pharmacology},
Abstract: Animal studies showed glucocorticoids could specifically dilate renal vasculature, regulate synthesis and release of atrial natriuretic peptide (ANP), upregulate ANP receptors on vascular endothelial cells, and thus have potent potentiating diuresis and natriuresis effects in animal studies; however, their diuretic efficacy in humans is yet to be known. Therefore, we designed this randomized, double- blind, placebo-controlled, clinical study to determine the diuretic efficacy of… 

Cardiac Outcome Prevention Effectiveness of Glucocorticoids in Acute Decompensated Heart Failure: COPE-ADHF Study

Limited data indicate that glucocorticoid therapy may be used safely in patients with acute decompensated heart failure in short term, and there was a remarkable SCr reduction after 7 days treatment.

Effect of Corticosteroid on Renal Water and Sodium Excretion in Symptomatic Heart Failure: Prednisone for Renal Function Improvement Evaluation Study

Only low-dose prednisone significantly enhanced urine output and renal sodium excretion, and high-dose Prednisone induced a more potent natriuresis and diuresis induced byprednisone.

Glucocorticoids completely reverse refractory diuretic resistance in a patient with decompensated heart failure and gross edema

The use of glucocorticoids is reported to reverse refractory diuretic resistance in a congestive heart failure patient who failed with intravenous administration of a high dose of furosemide (1000 mg/ day).

Prednisone adding to usual care treatment for refractory decompensated congestive heart failure.

Adding prednisone to conventional care in the patients with refractory DCHF induced potent diuresis accompanied by a dramatic relief of congestive symptoms and improvements in clinical status and renal function.

Hormone treatments in congestive heart failure

  • L. LeiY. Mao
  • Biology, Medicine
    The Journal of international medical research
  • 2018
Clinical trials indicate that in CHF patients with low insulin-like growth factor-1 or low thyroid hormone levels, supplemental treatment with growth hormone or thyroid hormone seems to be cardioprotective; and in CHf patients with volume overload the vasopressin antagonists can relieve the symptoms superior to loop diuretics.

Why Do Glucocorticoids Produce Potent and Persistent Diuresis Only in Subjects with Volume Overload Other Than Euvolemia

The diuresis induced by glucocorticoids was systemic volume dependent, which explained the phenomenon that glucoc Corticoids only have potent and persistent diuretic effect in congestive heart failure.



Glucocorticoid-induced renal vasodilatation is mediated by a direct renal action involving nitric oxide.

  • R. De MatteoC. May
  • Medicine, Biology
    American journal of physiology. Regulatory, integrative and comparative physiology
  • 1997
It is demonstrated that cortisol acts directly on the kidney to cause renal vasodilatation and to increase RBF and it is suggested that this response involves the endothelium-derived relaxing factor NO.

Effect of glucocorticoids on renal dopamine production.

Mechanism of the glucocorticoid-induced increase in glomerular filtration rate.

The rise in SNGFR following MP is entirely due to the increase in AQ, rather than to changes in the other determinants of ultrafiltration.

[Effect of glucocorticoids on electrolyte excretion after expansion of the extracellular space].

Intensification of the natriuretic response to the increase of the extracellular fluid volume against the background of glucocorticoids apparently occurred as a result of production or activation under the influence of these hormone of the rheumatoid factor.

Potentiation of atrial natriuretic peptide‐stimulated cyclic guanosine monophosphate formation by glucocorticoids in cultured rat renal cells

It is suggested that the diuretic action of glucocorticoids may, at least in part, be mediated through the potentiating effect of glucomethasone on cyclic GMP response to ANP.

Permissive action of glucocorticoid substitution therapy on the effects of atrial natriuretic peptide (hANP) in patients with adrenocortical insufficiency.

It is suggested that glucocorticoids may have a permissive effect on hANP-mediated natriuresis and diuresis, and plasma concentrations of ACTH, though markedly suppressed by dexamethasone as compared to the unsubstituted state were not influenced by exogenous h ANP either during deprival or substitution of glucoc Corticoids.

Regional hemodynamic and endocrine effects of aldosterone and cortisol in conscious sheep. Comparison with the effects of corticotropin.

These two endogenous steroids had contrasting, nonuniform regional hemodynamic effects, aldosterone causing mesenteric vasoconstriction, and cortisol causing renal vasodilatation.

FIGURE 2. An example of using prednisone as a potentiating diuretic agent in a patient with idiopathic dilated cardiomyopathy with significant fluid retention