The comparison of the diuretic and natriuretic efficacy of continuous and bolus intravenous furosemide in patients with chronic kidney disease

Srinivas, S.; Annigeri, Rajeev A; Seshadri, R.; Rao, Budithi Subba; Prakash, Kowdle Chandrasekhar; Mk, Mani

doi:10.1111/j.1440-1797.2007.00889.x

Cited by 22 publications

(13 citation statements)

References 22 publications

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“…The time course of the delivery of furosemide to its site of action may be affected by cardiac output [26], renal blood flow [27], and the route of furosemide administration. Furosemide infusion is, in general, more effective than boluses in inducing diuresis [28, 29], even in patients with hypoalbuminaemia [30]. The amount of furosemide secreted into the urine appears to be similar after either an intravenous bolus or infusion [19], and as such, the mechanism for the enhanced diuretic action of furosemide infusion may be related to its prolonged inhibition of Na‐K‐Cl 2 co‐transporters.…”

Section: Pharmacology Of Furosemidementioning

confidence: 99%

Benefits and risks of furosemide in acute kidney injury

Power²

2010

Anaesthesia

191

120

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SummaryFurosemide, a potent loop diuretic, is frequently used in different stages of acute kidney injury, but its clinical roles remain uncertain. This review summarises the pharmacology of furosemide, its potential uses and side effects, and the evidence of its efficacy. Furosemide is actively secreted by the proximal tubules into the urine before reaching its site of action at the ascending limb of loop of Henle. It is the urinary concentrations of furosemide that determine its diuretic effect. The severity of acute kidney injury has a significant effect on the diuretic response to furosemide; a good

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Section: Pharmacology Of Furosemidementioning

confidence: 99%

Benefits and risks of furosemide in acute kidney injury

Power²

2010

Anaesthesia

191

120

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“…In spite of the great importance of the adaptive phenomena related to the chronic use of furosemide, most studies investigating this drug have been performed in PD patients. Diuretics are drugs that are frequently used in clinical practice for treating edema and managing CKD patients [19]. The DOPPS study [8] verified that loop diuretics are those that are most often prescribed to HD patients, followed by thiazide diuretics and potassium-saving drugs.…”

Section: Discussionmentioning

confidence: 99%

Use of small doses of furosemide in chronic kidney disease patients with residual renal function undergoing hemodialysis

et al. 2011

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“…The concomitant use of i.v. diuretics with kaliuretic properties could contributed to the absence of hyperkalemia [19]. In clinical trials enrolling chronic HF patients, MRAs were well tolerated when patients with pCr N 2.5 mg/dL and serum potassium N 5 mmol/L were excluded [2,20].…”

Section: Discussionmentioning

confidence: 99%

Mineralocorticoid receptor antagonism in acutely decompensated chronic heart failure

Ferreira

Santos

Almeida

et al. 2014

European Journal of Internal Medicine

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Background/objectives: Mineralocorticoid receptor antagonist (MRA) use in acutely decompensated chronic heart failure (ADCHF) may improve congestion through diuretic effect and prevent neurohormonal activation. We aimed to evaluate the clinical effect and safety of spironolactone in ADCHF. Methods: Prospective, experimental, single-center, and single-blinded trial. Patients were treated with: standard ADCHF therapy or oral spironolactone 50-100 mg/d plus standard ADCHF therapy. Results: During a 1 year period, 100 patients were enrolled, 50 included in the treatment group. Mean (SD) spironolactone dose (mg) at day 1 was 94.5 ± 23.3 and at day 3 was 62.7 ± 24.3. Worsening renal function (increase in pCr ≥ 0.3 mg/dL from day 1 to day 3) was more likely to occur in control group (20% vs. 4%; p = 0.038), serum potassium did not differ between groups, and plasma NTproBNP had a significant decrease in spironolactone group at day 3 (median [IQR], 2488[IQR], [4579] vs. 1555[IQR], [1832; p = 0.05). Furthermore, a greater proportion of patients in the treatment group were free of congestion at day 3: less edema, rales, jugular venous pressure (JVP) and orthopnea (all, p b 0.05). In addition, a significantly higher proportion of patients were on oral furosemide at day 3 (44% vs. 82%; p b 0.001). Conclusions: Our study supports the safety of high dose spironolactone in ADCHF and suggests a positive impact in the resolution of congestion. The important findings of our pilot study need to be confirmed in larger trials.

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The comparison of the diuretic and natriuretic efficacy of continuous and bolus intravenous furosemide in patients with chronic kidney disease

Abstract: Continuous intravenous infusion of furosemide has significantly better natriuretic and diuretic effect than bolus administration of the same dose of the drug in patients with advanced chronic renal insufficiency.

Cited by 22 publications

References 22 publications

Benefits and risks of furosemide in acute kidney injury

Benefits and risks of furosemide in acute kidney injury

Use of small doses of furosemide in chronic kidney disease patients with residual renal function undergoing hemodialysis

Mineralocorticoid receptor antagonism in acutely decompensated chronic heart failure

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