Skip to main content
Top
Published in: Clinical and Experimental Nephrology 4/2011

01-08-2011 | Original Article

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

Authors: Helton P. Lemes, Salustiano Araujo, Daniella Nascimento, Danny Cunha, Cesar Garcia, Vinicius Queiroz, Sebastião R. Ferreira-Filho

Published in: Clinical and Experimental Nephrology | Issue 4/2011

Login to get access

Abstract

Background

The objective of the present study was to verify whether chronic renal patients on hemodialysis (HD) with residual diuresis who were using small doses of furosemide present different levels of urinary volume and sodium excretion compared to patients with residual diuresis who do not use this drug.

Methods

We studied 19 chronic renal patients on HD who presented any level of residual diuresis. Urine was collected during the 24-h interdialytic period, and physical examinations and blood sampling took place immediately before the start of HD. Patients were divided into two groups: the diuretic group (DG, n = 10), in which patients had been using 40 mg of furosemide for at least 3 months, and the non-diuretic group (NDG, n = 9), in which patients used no diuretics.

Results

Although both groups presented the same average glomerular filtration rate (p > 0.05) and time in dialysis (p > 0.05) the DG presented an average of twice the urinary volume in 24 h (1142 ± 184 vs. 453 ± 135 ml/24 h, respectively; p = 0.008) and double the total excreted sodium mass compared to patients in the NDG (112 ± 22.4 vs. 45.2 ± 16.0 mEq/24 h, respectively; p = 0.02).

Conclusion

The results of this study have shown that chronic use of small doses of furosemide in chronic renal patients with residual diuresis could increase urinary volume and sodium excretion compared to patients who did not use this drug.
Literature
1.
go back to reference Shemin D, Bostom AG, Laliberty P, Dworkin LD. Residual renal function and mortality risk in hemodialysis patients. Am J Kidney Dis. 2001;38(1):85–90.CrossRefPubMed Shemin D, Bostom AG, Laliberty P, Dworkin LD. Residual renal function and mortality risk in hemodialysis patients. Am J Kidney Dis. 2001;38(1):85–90.CrossRefPubMed
2.
go back to reference National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002;39 2 Suppl 1:S1–266. National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002;39 2 Suppl 1:S1–266.
3.
go back to reference Rottembourg J, Issad B, Gallego JL, Degoulet P, Aime F, Gueffaf B, Legrain M. Evolution of residual renal function in patients undergoing maintenance haemodialysis or continuous ambulatory peritoneal dialysis. Proc Eur Dial Transplant Assoc. 1983;19:397–403.PubMed Rottembourg J, Issad B, Gallego JL, Degoulet P, Aime F, Gueffaf B, Legrain M. Evolution of residual renal function in patients undergoing maintenance haemodialysis or continuous ambulatory peritoneal dialysis. Proc Eur Dial Transplant Assoc. 1983;19:397–403.PubMed
4.
go back to reference Lysaght MJ, Vonesh EF, Gotch F, Ibels L, Keen M, Lindholm B, et al. The influence of dialysis treatment modality on the decline of remaining renal function. ASAIO Trans. 1991;37(4):598–604.PubMed Lysaght MJ, Vonesh EF, Gotch F, Ibels L, Keen M, Lindholm B, et al. The influence of dialysis treatment modality on the decline of remaining renal function. ASAIO Trans. 1991;37(4):598–604.PubMed
5.
go back to reference Moist LM, Port FK, Orzol SM, Young EW, Ostbye T, Wolfe RA, et al. Predictors of loss of residual renal function among new dialysis patients. J Am Soc Nephrol. 2000;11(3):556–64.PubMed Moist LM, Port FK, Orzol SM, Young EW, Ostbye T, Wolfe RA, et al. Predictors of loss of residual renal function among new dialysis patients. J Am Soc Nephrol. 2000;11(3):556–64.PubMed
6.
go back to reference Medcalf JF, Harris KP, Walls J. Role of diuretics in the preservation of residual renal function in patients on continuous ambulatory peritoneal dialysis. Kidney Int. 2001;59(3):1128–33.CrossRefPubMed Medcalf JF, Harris KP, Walls J. Role of diuretics in the preservation of residual renal function in patients on continuous ambulatory peritoneal dialysis. Kidney Int. 2001;59(3):1128–33.CrossRefPubMed
7.
go back to reference Chandna SM, Farrington K. Residual renal function: considerations on its importance and preservation in dialysis patients. Semin Dial. 2004;17(3):196–201.CrossRefPubMed Chandna SM, Farrington K. Residual renal function: considerations on its importance and preservation in dialysis patients. Semin Dial. 2004;17(3):196–201.CrossRefPubMed
8.
go back to reference Bragg-Gresham JL, Fissell RB, Mason NA, Bailie GR, Gillespie BW, Wizemann V, et al. Diuretic use, residual renal function, and mortality among hemodialysis patients in the Dialysis Outcomes and Practice Pattern Study (DOPPS). Am J Kidney Dis. 2007;49(3):426–31.CrossRefPubMed Bragg-Gresham JL, Fissell RB, Mason NA, Bailie GR, Gillespie BW, Wizemann V, et al. Diuretic use, residual renal function, and mortality among hemodialysis patients in the Dialysis Outcomes and Practice Pattern Study (DOPPS). Am J Kidney Dis. 2007;49(3):426–31.CrossRefPubMed
9.
go back to reference Krediet RT, Douma CE, van Olden RW, Ho-dac-Pannekeet MM, Struijk DG. Augmenting solute clearance in peritoneal dialysis. Kidney Int. 1998;54(6):2218–25.CrossRefPubMed Krediet RT, Douma CE, van Olden RW, Ho-dac-Pannekeet MM, Struijk DG. Augmenting solute clearance in peritoneal dialysis. Kidney Int. 1998;54(6):2218–25.CrossRefPubMed
10.
go back to reference Boesken WH, Kult J. High-dose torasemide, given once daily intravenously for one week, in patients with advanced chronic renal failure. Clin Nephrol. 1997;48(1):22–8.PubMed Boesken WH, Kult J. High-dose torasemide, given once daily intravenously for one week, in patients with advanced chronic renal failure. Clin Nephrol. 1997;48(1):22–8.PubMed
11.
go back to reference van Olden RW, van Meyel JJ, Gerlag PG. Acute and long-term effects of therapy with high-dose furosemide in chronic hemodialysis patients. Am J Nephrol. 1992;12(5):351–6.CrossRefPubMed van Olden RW, van Meyel JJ, Gerlag PG. Acute and long-term effects of therapy with high-dose furosemide in chronic hemodialysis patients. Am J Nephrol. 1992;12(5):351–6.CrossRefPubMed
12.
go back to reference Ginsberg JM, Chang BS, Matarese RA, Garella S. Use of single voided urine samples to estimate quantitative proteinuria. N Engl J Med. 1983;309(25):1543–6.CrossRefPubMed Ginsberg JM, Chang BS, Matarese RA, Garella S. Use of single voided urine samples to estimate quantitative proteinuria. N Engl J Med. 1983;309(25):1543–6.CrossRefPubMed
13.
go back to reference Katopodis KP, Chasiotis G, Nikolopoulos P, Seferiadis K, Siamopoulos KC. The influence of 24 h urine sampling on the evaluation of renal dysfunction. Nephrol Dial Transplant. 2007;22(11):3360–2.CrossRefPubMed Katopodis KP, Chasiotis G, Nikolopoulos P, Seferiadis K, Siamopoulos KC. The influence of 24 h urine sampling on the evaluation of renal dysfunction. Nephrol Dial Transplant. 2007;22(11):3360–2.CrossRefPubMed
14.
go back to reference Rose B. Pathophysiology of renal disease. New York: McGraw-Hill; 1987. Rose B. Pathophysiology of renal disease. New York: McGraw-Hill; 1987.
15.
go back to reference Caravaca F, Arrobas M, Pizarro JL, Sanchez-Casado E. Uraemic symptoms, nutritional status and renal function in pre-dialysis end-stage renal failure patients. Nephrol Dial Transplant. 2001;16(4):776–82.CrossRefPubMed Caravaca F, Arrobas M, Pizarro JL, Sanchez-Casado E. Uraemic symptoms, nutritional status and renal function in pre-dialysis end-stage renal failure patients. Nephrol Dial Transplant. 2001;16(4):776–82.CrossRefPubMed
16.
go back to reference van Olden RW, Krediet RT, Struijk DG, Arisz L. Measurement of residual renal function in patients treated with continuous ambulatory peritoneal dialysis. J Am Soc Nephrol. 1996;7(5):745–50.PubMed van Olden RW, Krediet RT, Struijk DG, Arisz L. Measurement of residual renal function in patients treated with continuous ambulatory peritoneal dialysis. J Am Soc Nephrol. 1996;7(5):745–50.PubMed
17.
go back to reference Loon NR, Wilcox CS, Unwin RJ. Mechanism of impaired natriuretic response to furosemide during prolonged therapy. Kidney Int. 1989;36(4):682–9.CrossRefPubMed Loon NR, Wilcox CS, Unwin RJ. Mechanism of impaired natriuretic response to furosemide during prolonged therapy. Kidney Int. 1989;36(4):682–9.CrossRefPubMed
18.
go back to reference Russo D, Memoli B, Andreucci VE. The place of loop diuretics in the treatment of acute and chronic renal failure. Clin Nephrol. 1992;38(Suppl 1):S69–73.PubMed Russo D, Memoli B, Andreucci VE. The place of loop diuretics in the treatment of acute and chronic renal failure. Clin Nephrol. 1992;38(Suppl 1):S69–73.PubMed
19.
go back to reference Sanjay S, Annigeri RA, Seshadri R, Rao BS, Prakash KC, Mani MK. The comparison of the diuretic and natriuretic efficacy of continuous and bolus intravenous furosemide in patients with chronic kidney disease. Nephrology (Carlton). 2008;13(3):247–50.CrossRef Sanjay S, Annigeri RA, Seshadri R, Rao BS, Prakash KC, Mani MK. The comparison of the diuretic and natriuretic efficacy of continuous and bolus intravenous furosemide in patients with chronic kidney disease. Nephrology (Carlton). 2008;13(3):247–50.CrossRef
20.
go back to reference Schmidt P, Loew D, Dycka J, Kopsa H, Balcke P, Zazgornik J, Deutsch E. Comparison of the effects of muzolimine and furosemide in patients with end stage renal failure on chronic dialysis. Eur J Clin Pharmacol. 1981;20(1):23–6.CrossRefPubMed Schmidt P, Loew D, Dycka J, Kopsa H, Balcke P, Zazgornik J, Deutsch E. Comparison of the effects of muzolimine and furosemide in patients with end stage renal failure on chronic dialysis. Eur J Clin Pharmacol. 1981;20(1):23–6.CrossRefPubMed
21.
go back to reference van Olden RW, van Meyel JJ, Gerlag PG. Sensitivity of residual nephrons to high dose furosemide described by diuretic efficiency. Eur J Clin Pharmacol. 1995;47(6):483–8.CrossRefPubMed van Olden RW, van Meyel JJ, Gerlag PG. Sensitivity of residual nephrons to high dose furosemide described by diuretic efficiency. Eur J Clin Pharmacol. 1995;47(6):483–8.CrossRefPubMed
22.
go back to reference Vasavada N, Saha C, Agarwal R. A double-blind randomized crossover trial of two loop diuretics in chronic kidney disease. Kidney Int. 2003;64(2):632–40.CrossRefPubMed Vasavada N, Saha C, Agarwal R. A double-blind randomized crossover trial of two loop diuretics in chronic kidney disease. Kidney Int. 2003;64(2):632–40.CrossRefPubMed
23.
go back to reference Van Stone J. The effect of dialyzer membrane and etiology of kidney disease on the preservation of residual renal function in chronic hemodialysis patients. ASAIO J. 1995;41(3):M713–6.CrossRefPubMed Van Stone J. The effect of dialyzer membrane and etiology of kidney disease on the preservation of residual renal function in chronic hemodialysis patients. ASAIO J. 1995;41(3):M713–6.CrossRefPubMed
24.
go back to reference Hakim RM. Clinical implications of biocompatibility in blood purification membranes. Nephrol Dial Transplant. 2000;15(Suppl 2):16–20.CrossRefPubMed Hakim RM. Clinical implications of biocompatibility in blood purification membranes. Nephrol Dial Transplant. 2000;15(Suppl 2):16–20.CrossRefPubMed
25.
go back to reference Pertosa G, Grandaliano G, Gesualdo L, Schena FP. Clinical relevance of cytokine production in hemodialysis. Kidney Int Suppl. 2000;76:S104–11.CrossRefPubMed Pertosa G, Grandaliano G, Gesualdo L, Schena FP. Clinical relevance of cytokine production in hemodialysis. Kidney Int Suppl. 2000;76:S104–11.CrossRefPubMed
26.
go back to reference Smeby LC, Wideroe TE, Balstad T, Jorstad S. Biocompatibility aspects of cellophane, cellulose acetate, polyacrylonitrile, polysulfone and polycarbonate hemodialyzers. Blood Purif. 1986;4(1–3):93–101.CrossRefPubMed Smeby LC, Wideroe TE, Balstad T, Jorstad S. Biocompatibility aspects of cellophane, cellulose acetate, polyacrylonitrile, polysulfone and polycarbonate hemodialyzers. Blood Purif. 1986;4(1–3):93–101.CrossRefPubMed
27.
go back to reference Brater DC, Anderson SA, Brown-Cartwright D. Response to furosemide in chronic renal insufficiency: rationale for limited doses. Clin Pharmacol Ther. 1986;40(2):134–9.CrossRefPubMed Brater DC, Anderson SA, Brown-Cartwright D. Response to furosemide in chronic renal insufficiency: rationale for limited doses. Clin Pharmacol Ther. 1986;40(2):134–9.CrossRefPubMed
Metadata
Title
Use of small doses of furosemide in chronic kidney disease patients with residual renal function undergoing hemodialysis
Authors
Helton P. Lemes
Salustiano Araujo
Daniella Nascimento
Danny Cunha
Cesar Garcia
Vinicius Queiroz
Sebastião R. Ferreira-Filho
Publication date
01-08-2011
Publisher
Springer Japan
Published in
Clinical and Experimental Nephrology / Issue 4/2011
Print ISSN: 1342-1751
Electronic ISSN: 1437-7799
DOI
https://doi.org/10.1007/s10157-011-0427-z

Other articles of this Issue 4/2011

Clinical and Experimental Nephrology 4/2011 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.