Summary
The effect of IV frusemide was studied in six healthy young (mean age 26.5 years, range 21–33) and six healthy old (mean age 72.8 years, range 66–80) volunteers. A 24-h urine collection before frusemide showed no difference in volume and sodium excretion, although the old excreted less potassium. Creatinine clearance was significantly reduced in the older subjects. After frusemide, 20 mg IV, the pattern of sodium and water excretion over a 5-h period was different in the two groups. The peak effect was greater in the young and occurred within the first 30 min, but was delayed to between 30 and 60 min in the old. Thus in the young the time for 50% of the total sodium and water to be excreted was half that in the old. This delay in sodium and water excretion was related to baseline creatinine clearance. However, the total water, sodium and potassium excreted in the 5 h after frusemide did not differ in the two groups. These results suggest that the renal effects of frusemide are different in healthy elderly subjects as compared to the young. The delayed and reduced peak response is consistent with fewer nephrons in the elderly kidney.
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Lewis WH, Alving AS (1938) Changes with age in renal function in adult man. I. Clearance of urea. II. Amount of urea nitrogen in blood. III. Concentrating ability of the kidneys. Am J Physiol 123: 500–515
Davis DF, Shock NW (1950) Age changes in glomerular filtration rate, effective renal plasma flow and tubular excretory capacity in adult males. J Clin Invest 29: 496–507
McLachlan MSF (1978) The aging kidney. Lancet 2: 143–145
Darmady EM, Offer J, Woodhouse MA (1973) The parameters of the ageing kidney. J Pathol 109: 195–207
Thurston H, Bing RF, Pohl JEF, Swales JD (1978) Renin subgroups in essential hypertension: an analysis and critique. Quart J Med 47: 325–337
Kaplan NM, Kem DC, Holland OB, Kramer NJ, Higgins J, Gomez-Sanchez C (1976) The intravenous frusemide test, a simple way to evaluate renin responsiveness. Ann Intern Med 84: 639–645
Saruta T, Suzuki A, Hayaski M, Yasui T, Eguchi T, Dato E (1980) Mechanism of age related changes in renin and adrenocortical steroids. J Am Ger Soc 28: 210–214
Zadik Z, Kowarski A (1980) Normal integrated concentration of aldosterone and plasma renin activity: effect of age. J Clin Endocrinol Metab 50: 867–869
Meade TW, Imerson JD, Grodon D, Peart WS (1983) The epidemiology of plasma renin. Clin Sci 64: 274–280
Papper S (1973) The effects of age in reducing renal function. Geriatrics 28: 83–87
Leikola E, Vartia KO (1956) On penicillin levels in young and geriatric subjects. J Gerontol 11: 48–52
Ewy GA, Kapadia GG, Yao L, Lullin M, Marcus FI (1969) Digoxin metabolism in the elderly. Circulation 39: 449–453
Hansen JM, Kampmann J, Laursen H (1970) Renal excretion of drugs in the elderly. Lancet 1: 1170
Ackeson RM (1973) Blood pressure in a national sample of US adults. Percentile distribution by age, sex and race. Int J Epidemiol 2: 293–301
De Lean A, Munson PJ, Rodbard D (1978) Simultaneous analysis of families of sigmoidal curves: application to bioassay, radioligand assay, and physiological dose-response curves. Am J Physiol 235: E 97-E 102
Burg M, Stoner L, Cardinal J, Green N (1973) Furosemide effect on isolated perfused tubules. Am J Physiol 225: 119–124
Morgan T, Tadokoro M, Martin D, Berliner RW (1970) Effect of furosemide on Na+ and K+ transport, studied by microperfusion of rat nephron. Am J Physiol 218: 292–297
Deetjan P (1966) Micropuncture studies on site and mode of action of furosemide. Ann NY Acad Sci 139: 408–415
Epstein M, Hollenberg NK (1976) Age as determinant of renal sodium conservation in normal man. J Lab Clin Med 87: 411–417
Sunderam SG, Mankikar GD (1983) Hyponatraemia in the elderly. Age and ageing 12: 77–80
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Chaudhry, A.Y., Bing, R.F., Castleden, C.M. et al. The effect of ageing on the response to frusemide in normal subjects. Eur J Clin Pharmacol 27, 303–306 (1984). https://doi.org/10.1007/BF00542164
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DOI: https://doi.org/10.1007/BF00542164