Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Japan.
Division of Nephrology, Department of Internal Medicine, Tokyo Takanawa Hospital, Japan.
Intern Med. 2022 Feb 1;61(3):373-378. doi: 10.2169/internalmedicine.7896-21. Epub 2021 Aug 6.
We herein report two cases in which add-on acetazolamide to furosemide was effective for diuretic-resistant volume overload and hypercapnia. Case 1 was a woman in her 40s presenting with volume overload due to the nephrotic syndrome with diabetes mellitus. Case 2 was a man in his 60s with fluid overload and non-nephrotic proteinuria and sepsis. In both cases, although fluid overload was resistant to high-dose loop diuretics and complicated with hypercapnia due to pulmonary effusion, add-on acetazolamide administration resulted in symptom resolution. The additional effect of acetazolamide occurred regardless of the degree of proteinuria and kidney function.
我们在此报告两例在呋塞米的基础上加用乙酰唑胺治疗利尿剂抵抗性容量超负荷和高碳酸血症的病例。病例 1 为 40 多岁女性,因合并糖尿病的肾病综合征导致容量超负荷。病例 2 为 60 多岁男性,因肺部积液导致液体超负荷和非肾病性蛋白尿及脓毒症。在这两例患者中,尽管大容量负荷对大剂量袢利尿剂抵抗,且因胸腔积液并发高碳酸血症,但加用乙酰唑胺治疗后症状得到缓解。乙酰唑胺的附加作用与蛋白尿和肾功能的严重程度无关。