Diuretic Properties of Furosemide in Renal Disease

Muth, Robert G.

doi:10.7326/0003-4819-69-2-249

Cited by 58 publications

(18 citation statements)

References 11 publications

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“…Frusemide is a potent diuretic agent recommended as treatment for several disease states such as renal failure, (Allison & Kennedy, 1971;Muth, 1968) ascites of hepatic cirrhosis (Fuller, Khambatta & Gobezie, 1977) as well as congestive heart failure or pulmonary oedema (Krupp & Chatton, 1978). Although widely used, there are a few studies available on its pharmacokinetic disposition in different disease states and its pharmacodynamic effect has been the subject of contradictory reports.…”

Section: Introductionmentioning

confidence: 99%

Kinetic disposition and diuretic effect of frusemide in acute pulmonary oedema.

Perez¹,

Sitar²,

Ogilvie³

1980

Brit J Clinical Pharma

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1 The kinetic disposition and diuretic effect of frusemide was assessed in 16 patierts with acute pulmonary oedema utilizing a specific gas-liquid chromatographic assay for the drug. 2 Serum frusemide concentrations decayed biexponentially with wide variation in both oa half-life (range 15-79 min) and : half-life (range 127-1190 min). The # phase half-life was inversely related to creatinine clearance. 3 The apparent volume of distribution varied greatly among the patients (range 0.085-0.818 1/kg), and patients with an acute myocardial infarction had a larger peripheral kinetic compartment. 4 Patients with acute myocardial infarction excreted less unchanged drug and had a lesser urinary excretion of sodium and volume compared to patients without infarction. 5 The urinary excretion of sodium, chloride, calcium and volume was linearly related to the urinary excretion of unchanged frusemide.

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Section: Introductionmentioning

confidence: 99%

Kinetic disposition and diuretic effect of frusemide in acute pulmonary oedema.

Perez¹,

Sitar²,

Ogilvie³

1980

Brit J Clinical Pharma

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“…R eubi and C ottier [18] in their studies with chloro thiazide and mercurial diuretics in patients with different degrees of renal impairment, showed a sharp reduction in the diuretic and natriuretic action of these drugs when the GFR was below 15-20 inl/min. However, M u tii [13,14] was able to consistently induce a diuresis with frusemide in the presence of a creatinine clearance below 20 ml/min. High doses of frusemide are now commonly used in patients with chronic renal failure [1,11].…”

Section: Discussionmentioning

confidence: 99%

Use of Metolazone, a New Diuretic, in Patients with Renal Disease

Craswell¹,

Ezzat²,

Kopstein³

et al. 1974

Nephron

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Metolazone, a new diuretic/saluretic/anti-hypertensive agent related to quinethazone, was used to treat 20 patients with impaired renal function. Among eight water loaded hospitalized patients given metolazone 5 mg intra venously, glomerular filtration rate rose in four and diminished slightly in four while urine flow and sodium excretion in creased significantly. In 12 out-patients given long-term oral metolazone (usually 5–10 mg in single daily doses) treatment effectively removed oedema and induced weight loss; in the seven initially hypertensive patients blood pressure decreased also. Plasma renin activity was measured in seven patients before and after several weeks’ metolazone therapy. Activity fell in two patients and rose in five, but the upper limit of normal was exceeded in one only. Renal epithelial cell excretion rates indicated that drug nephrotoxicity was absent. Mean creatinine clearances rose, serum potassium levels fell, and ten patients received oral potassium supplements. Small transient increases in liver enzymes were seen in three patients. Metolazone tended to maintain glomerular filtration rate and renal plasma flow while increasing salt and water losses. A proximal as well as a distal site of action was suggested for the drug, and its anti-hypertensive effect was confirmed.

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“…Marjorie E. M. Allison and A. C. Kennedy McKenzie, Fairley & Baird, 1966;Gregory, Durrett, Robinson & Clapp, 1970) and ethacrynic acid (Maher & Schreiner, 1965) in such patients, especially when given in high doses (Muth, 1966(Muth, , 1968Dettli & Spring, 1966;Laragh, Cannon, Stason & Heinemann, 1966;McKenzie et al, 1966;Silverberg & Kjellstrand, 1968;Heidland, Klutsch, Moormann & Hennemann, 1969). We have carried out a further assessment by studying acutely the efficacy and mode of action of high dosage frusemide in twenty-four patients with various types of advanced stable non-oedematous chronic renal disease.…”

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confidence: 93%

Diuretics in Chronic Renal Disease: A Study of High Dosage Frusemide

Allison

Kennedy

1971

Clinical Science

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1. The efficacy and mode of action of frusemide (100-750 mg) have been studied acutely in thirty-four investigations on twenty-four water-loaded subjects with stable, non-oedematous chronic renal disease (GFR 2,3-26'0 ml/min) of varying aetiology (fourteen 'tubular', ten 'glomerular').2. Water loading alone resulted in a slight increase in urine flow rate, a flowdependent rise in electrolyte excretion and a small fall in urine osmolality.3. Basal fractional excretion of fluid and electrolytes was closely related to GFR, increasing as this fell, so that at a GFR of 3·0 ml/min 80% of the fluid filtered, 50-60% of the filtered load of sodium and chloride and 400% of potassium was excreted. 4. After oral or intravenous frusemide, up to 93% of the filtered load of chloride, 87% of sodium and apparently all of the glomerular filtrate could be excreted; the magnitude of the response depended on dose, GFR and basal fractional sodium excretion, being greatest at higher GFR and lowest fractional excretion. Free water clearance increased. 5. No significant change in inulin clearance was found after frusemide and no difference in the response of 'tubular' as opposed to 'glomerular' subjects.6. Long-term treatment of nineteen patients with 'resistant' oedema and chronic renal disease has shown high dosage frusemide (0,12-2,0 gJday) to be an effective diuretic, although significant side effects were found in five patients.In the past, diuretic therapy was considered of little value, and perhaps even harmful. in patients with advanced renal impairment. The organo-mercurials and thiazides are ineffective in patients with glomerular filtration rates (GFR) less than 15-20 nil/min (Reubi & Cottier,

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Diuretic Properties of Furosemide in Renal Disease

Cited by 58 publications

References 11 publications

Kinetic disposition and diuretic effect of frusemide in acute pulmonary oedema.

Kinetic disposition and diuretic effect of frusemide in acute pulmonary oedema.

Use of Metolazone, a New Diuretic, in Patients with Renal Disease

Diuretics in Chronic Renal Disease: A Study of High Dosage Frusemide

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