Knauf H, Mutschler E
Medizinische Klinik I, St. Bernward-Krankenhaus, Hildesheim, FRG.
Eur J Clin Pharmacol. 1990;39(4):337-43. doi: 10.1007/BF00315406.
The effects of torasemide have been studied in 7 healthy controls and 9 patients with stable chronic renal failure of various degrees. After a control period of 3 days torasemide 20 mg i.v. caused a dramatic increase in diuresis and electrolyte excretion without affecting the glomerular filtration rate. The duration of action of torasemide, tau, averaged 6 h and was independent of the creatinine clearance, CLCR. When related to tau the drug-induced excretion of Cl-, Na+, K+, Ca2+ and Mg2+ showed strong linear dependence on CLCR. Both the kaliuresis and the calciuresis during tau were tightly correlated with the natriuresis over the broad range of CLCR. Similarly, the excretion of Mg2+ was dependent on the kaliuresis. The torasemide-induced kaliuresis amounted to 12% of natriuresis, as after furosemide. The kaliuretic effect of loop diuretics is smaller than that of the thiazides. After tau, e.g. over a 24 h period, kaliuresis was not correlated with natriuresis. The magnitude of the rebound effect was diminished with increasing renal impairment.
已在7名健康对照者和9名不同程度稳定慢性肾衰竭患者中研究了托拉塞米的作用。在3天的对照期后，静脉注射20 mg托拉塞米可使利尿和电解质排泄显著增加，而不影响肾小球滤过率。托拉塞米的作用持续时间τ平均为6小时，且与肌酐清除率CLCR无关。当与τ相关时，药物诱导的Cl-、Na+、K+、Ca2+和Mg2+排泄与CLCR呈强烈线性相关。在τ期间，钾利尿和钙利尿在广泛的CLCR范围内均与钠利尿紧密相关。同样，Mg2+的排泄取决于钾利尿。托拉塞米诱导的钾利尿占钠利尿的12%，与呋塞米后的情况相同。袢利尿剂的钾利尿作用小于噻嗪类利尿剂。例如在τ之后，在24小时期间，钾利尿与钠利尿不相关。随着肾功能损害加重，反跳效应的程度减小。
