How would you approach managing severe, functionally disabling steroid induced edema that is refractory to treatment with chlorthalidone or bumetanide?

This is a difficult issue - I'm assuming the patient is unable to taper steroids at this time. The edema results from the mineralocorticoid activity of the steroid, so attempting to change to a low or negligible mineralocorticoid corticosteroid may be helpful if possible - dexamethasone, betamethaso...