University Clinic in Nephrology and Hypertension, Department of Medicine, University of Aarhus and Gødstrup Hospital, Holstebro, Denmark.
Department of Biomedicine, Aarhus University, Aarhus, Denmark.
Physiol Rep. 2021 Jan;8(24):e14653. doi: 10.14814/phy2.14653.
Furosemide inhibits the sodium potassium chloride cotransporter (NKCC2) in the thick ascending limb of the loop of Henle and increases urinary water and sodium excretion. This study investigates the effect of furosemide on body composition estimated with multifrequency bioimpedance spectroscopy (BIS) technique and urinary proteins from NKCC2.
This study is a randomized, placebo-controlled, crossover study where healthy subjects received either placebo or 40 mg furosemide on two separate occasions, where body composition with BIS, renal function, proteins from tubular proteins that mediate sodium and water transport, and plasma concentrations of vasoactive hormones were measured before and after intervention.
We observed an expected increased diuresis with a subsequent reduction in bodyweight of (-1.51 ± 0.36 kg, p < .001) and extracellular water (ECW; -1.14 ± 0.23 L, p < .001) after furosemide. We found a positive correlation between the decrease in ECW and a decrease in bodyweight and a negative correlation between the decrease in ECW and the increase in urinary output. Intracellular water (ICW) increased (0.47 ± 0.28 L, p < .001). Urinary excretion of NKCC2 increased after furosemide and the increase in NKCC2 correlated with an increase in urine output and a decrease in ECW.
We found BIS can detect acute changes in body water content but the method may be limited to estimation of ECW. BIS demonstrated that furosemide increases ICW which might be explained by an extracellular sodium loss. Finally, urinary proteins from NKCC2 increases after furosemide with a good correlation with diuresis end the decrease in ECW.
呋塞米抑制升支粗段的钠钾氯协同转运蛋白（NKCC2），增加尿水和钠排泄。本研究探讨了呋塞米对多频生物电阻抗谱（BIS）技术估计的身体成分和 NKCC2 尿蛋白的影响。
这是一项随机、安慰剂对照、交叉研究，健康受试者在两次不同的时间接受安慰剂或 40mg 呋塞米，在干预前后测量身体成分（BIS）、肾功能、介导钠和水转运的管状蛋白蛋白和血管活性激素的血浆浓度。
我们观察到预期的利尿作用，随后体重（-1.51±0.36kg，p<0.001）和细胞外液（ECW；-1.14±0.23L，p<0.001）减少。我们发现 ECW 减少与体重减轻呈正相关，ECW 减少与尿排量增加呈负相关。细胞内液（ICW）增加（0.47±0.28L，p<0.001）。呋塞米后 NKCC2 的尿排泄增加，NKCC2 的增加与尿排量增加和 ECW 减少相关。
我们发现 BIS 可以检测到身体水分含量的急性变化，但该方法可能仅限于估计 ECW。BIS 表明，呋塞米增加了 ICW，这可能是由于细胞外钠丢失所致。最后，NKCC2 的尿蛋白在呋塞米后增加，与利尿作用和 ECW 减少呈良好相关性。
