Vargas R, Cuevas J, López E
Bol Med Hosp Infant Mex. 1977 Nov-Dec;34(6):1317-30.
The study included 13 infants under one year complaining of acute gastroenteritis and dehydration who were still in oliguria or anuria 6 hours after rehydration was initiated. They were given a single dose of furosemide at the rate of 1 mg/kg and indices of U/P of urea and osmolarity, ratio urea/plasmatic creatinine, urinary volume, natriuresis and evolution of urea plasmatic figures and of creatinine were determined. Four patients showed no response to the diuretic; all of them died and through clinical and histopathologic evaluation they were classified as having acute renal insufficiency (IRA). The nine patients showing response to the drug with an increase of 5 to 30 times the control figure for urine and natriuresis showed an index U/P of urea of 5.52 +/- 3.82, U/P of osmolarity of 1.32 +/- 09, ratio urea/plasmatic creatinine of 58.7 +/- 19.8 and the figures for urea and creatinine in blood turned normal within 2 to 4 days. This was classed as prerenal azotemia (APR). It is thus concluded that furosemide appears to be a good parameter to make an early differentiation of cases with IRA, but that this measure, the same as the rest of the indices cannot show an absolute value since there are important variations in each individual.
该研究纳入了13名不满一岁的婴儿，他们因急性肠胃炎和脱水入院，在补液开始6小时后仍处于少尿或无尿状态。给他们单次静脉注射速尿，剂量为1mg/kg，并测定尿素的尿/血（U/P）比值、渗透压的尿/血（U/P）比值、尿素/血浆肌酐比值、尿量、尿钠排泄，以及尿素和肌酐的血浆指标变化。4名患者对利尿剂无反应，均死亡，经临床和组织病理学评估，被判定为急性肾功能不全（IRA）。另外9名对药物有反应的患者，尿量和尿钠排泄增加了5到30倍，其尿素的尿/血（U/P）比值为5.52±3.82，渗透压的尿/血（U/P）比值为1.32±0.09，尿素/血浆肌酐比值为58.7±19.8，血液中的尿素和肌酐值在2至4天内恢复正常，被判定为肾前性氮质血症（APR）。由此得出结论，速尿似乎是早期鉴别IRA病例的良好指标，但与其他指标一样，由于个体差异较大，该指标无法提供绝对的诊断依据。
