Abstract: Heart failure is the final stage of the development of various heart diseases. In recent years, the prevalence of
heart failure in China has gradually increased and is becoming the most important cardiovascular disease in the 21 st
century. Diuretics are the key and basis for the treatment of heart failure. The drug treatment of heart failure mainly includes two aspects, one is to delay the progress of the disease, mainly including endorphin inhibitor (sakutravalsartan), angiotensin converting enzyme inhibitor (ACEI), angiotensin II receptor antagonist (ARB), beta blocker, aldosterone receptor antagonist and other drugs; the other is to improve symptoms such as dyspnea and edema, including diuretics and vasodilators. Considering the key role of congestion in heart failure, diuretics are the cornerstone of heart failure treatment. However, due to various reasons, 25% -30% of the patients have diuretic resistance, which significantly reduces the therapeutic effect in patients with heart failure. This article reviews the definition, pathogenesis and therapeutic strategy of diuretic resistance.

Key words: heart failure, diuretics,osmotic, diuretic resistance