Berg K J, Tromsdal A, Wideroe T E
Eur J Clin Pharmacol. 1976 Feb 6;9(4):265-75. doi: 10.1007/BF00561659.
The effect of bumetanide, a new potent diuretic, was studied in twelve patients with severe chronic renal failure (GFR 2.7 - 10.7 ml/min). Bumetanide 8 mg i.v. caused increased excretion of water and sodium in all patients. In some patients sodium excretion was greater than 50% of filtered load indicating an effect on proximal tubules. Bumetanide 2 mg i.v. was significantly less effective than 8 mg and a greater diuretic effect was produced by bumetanide 16 mg. In a comparative study bumetanide 8 mg was less potent than furosemide 250 mg, a finding in contrast to the potency rate ratio of 1/40 in other conditions. Side effects consisted of mild to moderate muscle pain and stiffness, especially localized in the neck, shoulders and calves. These side effects occurred only in patients with a GFR less than 5.3 ml/min. They were noted in all patients receiving 16 mg and in 3 out of 12 patients who took bumetanide 8 mg. There was no relationship between the occurrence of side effects and plasma bumetanide levels, electrolyte levels or the renal excretion of bumetanide and electrolytes.
研究了新型强效利尿剂布美他尼对12例严重慢性肾衰竭患者（肾小球滤过率为2.7 - 10.7 ml/分钟）的作用。静脉注射8毫克布美他尼可使所有患者的水和钠排泄增加。在一些患者中，钠排泄量大于滤过负荷的50%，表明对近端小管有作用。静脉注射2毫克布美他尼的效果明显不如8毫克，而16毫克布美他尼产生的利尿作用更强。在一项对比研究中，8毫克布美他尼的效力低于250毫克呋塞米，这一发现与其他情况下1/40的效价比相反。副作用包括轻度至中度的肌肉疼痛和僵硬，尤其集中在颈部、肩部和小腿。这些副作用仅发生在肾小球滤过率低于5.3 ml/分钟的患者中。在所有接受16毫克布美他尼的患者以及12例服用8毫克布美他尼的患者中的3例中观察到了这些副作用。副作用的发生与血浆布美他尼水平、电解质水平或布美他尼及电解质的肾排泄之间没有关系。
