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在进行血液透析的残余肾功能的慢性肾脏病患者中使用小剂量呋塞米。

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

机构信息

Nefroclínica de Uberlândia, Rua Paraíba 3055, 38400-000 Uberlândia, MG, Brazil.

出版信息

Clin Exp Nephrol. 2011 Aug;15(4):554-9. doi: 10.1007/s10157-011-0427-z. Epub 2011 Mar 18.

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.

摘要

背景

本研究的目的是验证残余尿量的慢性肾透析(HD)患者在使用小剂量呋塞米时,与未使用该药物的残余尿量患者相比,其尿量和钠排泄量是否存在差异。

方法

我们研究了 19 名存在残余尿量的慢性肾 HD 患者。在透析间期 24 小时内收集尿液,并在开始 HD 前立即进行体格检查和采血。患者被分为两组:利尿剂组(DG,n=10),患者至少使用 40mg 呋塞米 3 个月;非利尿剂组(NDG,n=9),患者未使用利尿剂。

结果

尽管两组的平均肾小球滤过率(p>0.05)和透析时间(p>0.05)相同,但 DG 的 24 小时尿量平均是 NDG 的两倍(分别为 1142±184 vs. 453±135ml/24h;p=0.008),并且与 NDG 相比,DG 的总钠排泄量也增加了一倍(分别为 112±22.4 vs. 45.2±16.0mEq/24h;p=0.02)。

结论

本研究结果表明,与未使用该药物的患者相比,残余尿量的慢性肾患者长期小剂量使用呋塞米可增加尿量和钠排泄。

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