Coadministration of albumin and furosemide in patients with the nephrotic syndrome

Details

Serval ID
serval:BIB_EE7DFD537775
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Coadministration of albumin and furosemide in patients with the nephrotic syndrome
Journal
Kidney International
Author(s)
Fliser  D., Zurbruggen  I., Mutschler  E., Bischoff  I., Nussberger  J., Franek  E., Ritz  E.
ISSN
0085-2538 (Print)
Publication state
Published
Issued date
02/1999
Volume
55
Number
2
Pages
629-34
Notes
Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't --- Old month value: Feb
Abstract
BACKGROUND: In patients with nephrotic syndrome, the natriuretic effect of furosemide (FU) is diminished. The effect of coadministration of FU and human albumin (HA) has remained controversial. METHODS: In a double-blind, placebo-controlled study, nine nephrotic patients (six males, 48 +/- 4 years) on standardized sodium chloride intake, in random order on three separate days, received by intravenous administration for 60 minutes either (a) 60 mg FU plus a sham infusion, (b) 60 mg FU plus 200 ml of a 20% solution of HA, or (c) sham infusion plus 200 ml of a 20% solution of HA. Urinary volume, sodium, albumin and FU excretion, renal hemodynamics, and plasma atrial natriuretic factor concentration were assessed. RESULTS: Administration of FU alone significantly (P < 0.01) increased mean cumulative urinary sodium (259 +/- 30 mmol) and volume excretion (2684 +/- 167 ml) in the first eight hours as compared with the HA infusion alone (118 +/- 12 mmol, 1827 +/- 141 ml). The coadministration of FU and HA caused an even more marked increase (P < 0.01 vs. HA alone) of urinary sodium (312 +/- 28 mmol) and volume excretion (3230 +/- 201 ml); the difference to FU administration alone was significant (P < 0.05). Plasma atrial natriuretic factor, serum albumin concentration, and urinary albumin excretion increased significantly on both HA infusion days, whereas urinary excretion of FU remained unchanged with HA coadministration. Glomerular filtration rate (CIn) was not significantly affected by any of the infusion protocols, but effective renal plasma flow (CPAH) increased significantly on both HA infusion days. CONCLUSIONS: Coadministration of HA potentiates the action of FU in patients with the nephrotic syndrome, but only modestly. This effect is mediated by changes in renal hemodynamics.
Keywords
Adult Albuminuria/urine Atrial Natriuretic Factor/blood Cross-Over Studies Diuresis/drug effects Double-Blind Method Drug Combinations Drug Synergism Female Furosemide/*therapeutic use Humans Infusions, Intravenous Male Middle Aged Natriuresis/drug effects Nephrotic Syndrome/*drug therapy/physiopathology Renal Circulation/drug effects Serum Albumin/analysis/*therapeutic use
Pubmed
Web of science
Open Access
Yes
Create date
05/03/2008 17:41
Last modification date
20/08/2019 17:16
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