Summary
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 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.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Allison, M., Kennedy, A.C.: Diuretics in chronic renal disease. Clin. Sci.41, 171–187 (1971)
Asbury, M.J., Gatenby, P.B.B., O'Sullivan, S., Bourke, E.: Bumetanide: Potent new “loop” diuretic. Brit. med. J.1972 I, 211–213
Berg, K.J., Gisholt, K., Widerøe, T.-E.: Bumetanide (Burinex Leo) — Et nytt potent diuretikum. T. norske Lægeforen.93, 843–846 (1973)
Bollerup, A.C., Hesse, B., Sigurd, B.: Changes of glomerular filtration rate and renal plasma flow following intravenous bumetanide in organic heart disease. Acta pharmacol. (Kbh.)34, 305–312 (1974)
Bourke, E., Asbury, M.J., O'Sullivan, S., Gatenby, P.B.B.: The sites of action of bumetanide in man. Europ. J. Pharmacol.23, 283–289 (1973)
Burmeister, H., Ohlmeier, H., Baethke, R.: Nebenwirkungen und Komplikationsmöglichkeiten der Furosemidtherapie in hoher Dosierung. Med. Klin.67, 1401–1405 (1972)
Calesnic, B., Christensen, J.A., Richter, M.: Absorption and excretion of furosemide — S35 in human subjects. Proc. Soc. exp. Biol. (N.Y.)123, 17–22 (1966)
Cutler, R.E., Forrey, A.W., Graham Christopher, T., Kimpel, B.M.: Pharmacokinetics of furosemide in normal subjects and functionally anephric patients. Clin. Pharmacol. Ther.15, 588–596 (1974)
Davies, D.L., Lant, A.F., Millard, N.R., Smith, A.J., Ward, J.W., Wilson, G.M.: Renal action, therapeutic use and pharmacokinetics of the diuretic bumetanide. Clin. Pharmacol. Ther.15, 141–155 (1974)
Dikshit, K., Vyden, J.K., Forrester, J.S., Chatterjee, K., Prakash, R., Sevan, H.J.C.: Renal and extrarenal hemodynamic effects of furosemide in congestive heart failure after acute myocardic infarction. New Engl. J. Med.288, 1087–1090 (1973)
Feit, P.W.: Amino acid diuretics. 2. 4-substituted-3-amino-5-sulfamylbenzoic acid derivaties. J. med. Chem.14, 432–439 (1971)
Feit, P.W., Roholt, K., Sörensen, H.: GLC determination and urine recovery of bumetanide in healthy volunteers. J. pharm. Sci.62, 375–379 (1973)
Hofstetter, A.: Bumetanide, a new diuretic. Int. Urol. Nephrol.6, 35–42 (1974)
Hook, J.B., Blatt, A.H., Brody, M.J., Williamson, H.E.: The effects of several saluretic diuretic agents on renal haemodynamics. J. Pharmacol. exp. Ther.154, 667–673 (1966)
Huang, C.M., Atkinson, A.J., Levin, N.W., Quintanilla, A.: Pharmacokinetics of furosemide in advanced renal failure. Clin. Pharmacol. Ther.16, 659–666 (1974)
Jewkes, R.F., Burki, N., Guz, A.: Observations on renal function in patients undergoing therapeutic diuresis with frusemide. Clin. Sci.38, 439–449 (1970)
Karlander, S.-G., Henning, R., Lundevall, O.: Renal effects of bumetanide, a new saluretic agent. Europ. J. clin. Pharmacol.6, 220–223 (1973)
Maschio, G., Mioni, G., D'Angello, A., Ossi, E., Valvo, E., Lupo, A.: Effects of high doses of frusemide on plasma and muscle electrolytes in patients with chronic renal failure. Nephron13, 235–244 (1974)
Moult, P.J.A., Lunzer, M.R., Trosh, D.B., Sherlock, S.: Use of bumetanide in the treatment of ascites due to liver disease. Gut15, 988–992 (1974)
Olesen, K.H., Sigurd, B., Steiness, E., Leth, A.: Bumetanide, a new potent diuretic. Acta med. scand.193, 119–131 (1973)
Radó, J.P., Juhos, E., Szend, L., Marosi, J., Takó, J., Salamon, F.: Acute renal effects of high doses furosemide administered intravenously in patients with advanced chronic renal insufficiency. J. Med.4, 219–232 (1973)
Reubi, F.C.: Clinical use of furosemide. Ann. N.Y. Acad. Sci.139, 433–442 (1966)
Ring-Larsen, H.: Bumetanide in the treatment of hepatic ascites. Acta med. scand.195, 411–414 (1974)
Runeberg, L., Pasternack, A., Borgmästars, H., von Bonsdorff, M.: Clinical trial of a new diuretic, bumetanide, in seriously ill patients. Ann. clin. Res.6, 272–278 (1974)
Rupp, W., Heidland, A., Neuhaus, G.: Pharmakokinetik von Furosemid bei normaler und eingeschränkter Nierenfunktion. 4. Freiburger Tagung über Fortschritte der Nephrologie 1970. Stuttgart: Thieme 1971
Stewart, W.K., Fleming, L.W., Manuel. M.A.: Muscle cramps during maintenance haemodialysis. Lancet1972 I, 1049–1051
Vorburger, C.: Die akute Wirkung des Diureticums Furosemid auf das Glomerulumfiltrat, die renale Hämodynamik, die Wasser-, Clorid- und Kaliumausscheidung und auf den Sauerstoffverbrauch der Nieren. Klin. Wschr.42, 833–839 (1964)
Wesson, jr., L.G.: Physiology of the human kidney. New York: Grune & Stratton 1969
Østergaard, E.H., Magnussen, M.P., Karlgaard Nielsen, C., Eilertsen, E., Frey, H.-H.: Pharmacological properties of 3-n-butylamin-4-phenoxy-5-sulfamylbenzoic acid (bumetanide), a new potent diuretic. Arzneimittel-Forsch.22, 66–72 (1972)
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Berg, K.J., Tromsdal, A. & Widerøe, T.E. Diuretic action of bumetanide in advanced chronic renal insufficiency. Eur J Clin Pharmacol 9, 265–275 (1976). https://doi.org/10.1007/BF00561659
Received:
Revised:
Issue Date:
DOI: https://doi.org/10.1007/BF00561659