Sanjay Srinivas, Annigeri Rajeev A, Seshadri Rajagopalan, Rao Budithi Subba, Prakash Kowdle C, Mani Muthu Krishna
Department of Nephrology, Apollo Hospitals, Chennai, India.
Nephrology (Carlton). 2008 Jun;13(3):247-50. doi: 10.1111/j.1440-1797.2007.00889.x.
To compare natriuretic, kaliuretic, diuretic and free water clearance efficacy of continuous versus bolus intravenous furosemide administration in patients with chronic renal insufficiency.
In a prospective randomized cross-over trial, 42 patients of chronic renal insufficiency were randomized to receive the same dose of intravenous furosemide as bolus and continuous infusion. The effects of bolus and intravenous administration of furosemide on the volume of urine, sodium and potassium excretion were assessed.
Mean age was 53.6 +/- 14 years and 23 (55%) were male. The mean modification of diet in renal disease glomerular filtration rate was 20.5 +/- 17 mL/min per 1.73 m(2). The urinary excretion of sodium in intravenous bolus and infusion was 98.1 +/- 78 and 114.4 +/- 100 mmol, respectively (P = 0.001). Total urinary volume following bolus and infusion of furosemide was 1064 +/- 627 and 1170 +/- 764 mL, respectively (0.001). The excretion of potassium was similar in bolus (15.8 +/- 16.6) and infusion (14.3 +/- 9) administration (P = 0.11). The fractional excretion of sodium was higher following infusion (16.63 +/- 16.1) than bolus administration (12.87 +/- 9) of furosemide (P = 0.016).
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.
比较持续静脉输注与大剂量静脉注射速尿对慢性肾功能不全患者的利钠、利钾、利尿及自由水清除效果。
在一项前瞻性随机交叉试验中，42例慢性肾功能不全患者被随机分为接受相同剂量速尿的大剂量注射组和持续输注组。评估速尿大剂量注射和静脉输注对尿量、钠和钾排泄量的影响。
平均年龄为53.6±14岁，男性23例（55%）。肾脏疾病肾小球滤过率的平均饮食调整为每1.73平方米20.5±17毫升/分钟。静脉大剂量注射和输注时钠的尿排泄量分别为98.1±78和114.4±100毫摩尔（P = 0.001）。速尿大剂量注射和输注后的总尿量分别为1064±627和1170±764毫升（P = 0.001）。大剂量注射（15.8±16.6）和输注（14.3±9）时钾的排泄量相似（P = 0.11）。速尿输注后钠的分数排泄（16.63±16.1）高于大剂量注射（12.87±9）（P = 0.016）。
对于晚期慢性肾功能不全患者，持续静脉输注速尿的利钠和利尿效果明显优于相同剂量的大剂量注射。
