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High doses of furosemide in children with acute renal failure

A preliminary retrospective study

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Abstract

The diuretic effect of high doses of furosemide alone and furosemide plus maniitol was analysed retrospectively in 30 children with acute renal failure. In 10 children (Group 1) renal failure developed mainly during glomerulonephritis, and in 20 children (Group 2) the cause was gastroenteritis. The diuretic effects of furosemide and furosemide plus mannitol were evaluated measuring the 24-hour urine volume at the time of anuria, oliguria or normal diuresis. The highest mean single intravenous doses of furosemide were 6.5 and 14 mg/kg in Groups 1 and 2, respectively; the highest average daily doses were 10.1 and 25.5 mg/kg, respectively. A broad relationship was observed between single i.v. dose and diuretic response following administration of furosemide (1.2 to 30.8 mg/kg). In both groups of patients a statistically significant negative linear correlation was found between the daily intravenous dose of furosemide and the 24-hour urine volume. Calculations based on the obtained regression equations showed that the expected 24-hour urine volumes corresponding to daily diuresis normal for age could be obtained after administration of daily 2.8 to 1.4 mg/kg furosemide in Group 1 and 9.3 to 2.3 in Group 2. It is therefore suggested that the total daily dose of furosemide should not exceed 100 mg in children with acute renal failure. Administration of furosemide plus mannitol did not result in higher daily diuresis as compared to 24-hour urine volume obtained when furosemide was given alone. Furosemide was well tolerated. Electrolyte disturbances, especially in Group 2, were the most frequent side effects due to high doses of furosemide.

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References

  1. Arneil, G. C., Carr-Saunders, E.: Diuretics and hypotensive agents. In: Burland, W. R., Laurance, B. M. (eds): The Therapeutic Choice in Paediatrics. Churchill-Livingstone, Edinburgh 1972.

    Google Scholar 

  2. Beermann, B., Dalén, E., Lindström, B.: Elimination of furosemide in healthy subjects and in those with renal failure.Clin. Pharmacol. Ther., 22, 70 (1977).

    PubMed  CAS  Google Scholar 

  3. Beroniade, V.: Furosemide in acute and chronic renal failure.Proc. Eur. Dial. Transplant. Ass., 5, 241 (1968).

    Google Scholar 

  4. Brown, C. B., Ogg, C. S., Cameron, J. S.: High dose frusemide in acute renal failure: a controlled trial.Clin. Nephrol., 15, 90 (1981).

    PubMed  CAS  Google Scholar 

  5. Cantarovich, F. K., Locatelli, A., Fernandez, J. C.: Furosemide in high doses in the treatment of acute renal failure.Postgrad. Med. J.,47, Suppl. 13 (1971).

    Google Scholar 

  6. Epstein, M., Schneider, N. S., Befeler, B.: Effect of furosemide on renal function and intrarenal hemodynamics in acute renal failure.Am. J. Med., 58, 510 (1975).

    Article  PubMed  CAS  Google Scholar 

  7. Fildes, R. D., Springate, J. E., Feld, L. G.: Acute renal failure. II. Management of suspected and established disease.J. Pediatr., 109, 567 (1986).

    Article  PubMed  CAS  Google Scholar 

  8. Finn, W. F.: Acute renal failure. In: Earley, L. E., Gottschalk, C. W. (eds): Strauss and Welt’s Diseases of the Kidney, 3rd ed. Little Brown and Co., New York 1979.

    Google Scholar 

  9. Fries, D., Pozet, N., Dubois, N., Traeger, J.: The use of large doses of frusemide in acute renal failure.Postgrad. Med. J.,47, Suppl. 18 (1971).

    Google Scholar 

  10. Gaudio, K. M., Siegel, N. J.: Pathogenesis and treatment of acute renal failure.Pediatr. Clin. N. Amer., 34, 771 (1987).

    CAS  Google Scholar 

  11. Graziani, G., Cantaluppi, A., Casati, S., Citterio, A., Scalamogna, A., Aroldi, A., Silenzio, R., Brancaccio, D., Boticelli, C.: Dopamine and frusemide in oliguric acute renal failure.Nephron, 37, 39 (1984).

    PubMed  CAS  Google Scholar 

  12. Hollenberg, N. K., Epstein, M., Buttman, R. D., Conroy, M., Basch, R. I., Merril, J. P.: Effect of sodium balance on intrarenal distribution of blood flow in normal man.J. Appl. Physiol., 28, 312 (1970).

    PubMed  CAS  Google Scholar 

  13. Huang, C. M., Atkinson, A. J. Jr., Levin, M., Levin, N. W., Quintanilla, A.: Pharmacokinetics of furosemide in advanced renal failure.Clin. Pharmacol. Ther., 16, 659 (1974).

    PubMed  CAS  Google Scholar 

  14. Kaojarern, S., Day, B., Brater, D. C.: The time course of delivery of furosemide into urine: an independent determinant of overall response.Kidney Int., 22 69 (1982).

    PubMed  CAS  Google Scholar 

  15. Kaplan, B. S., Drummond, K. N.: Acute renal failure. In: Rubin, M. I., Barrat, T. M. (eds): Pediatric Nephrology. The Williams and Wilkins Co., Baltimore 1975.

    Google Scholar 

  16. Krongrad, E. Joos, H. A.: Furosemide in treatment of edema in infants and children.N.Y. State J. Med., 71, 2521 (1971).

    PubMed  CAS  Google Scholar 

  17. Levinsky, N. G., Bernard, D. B., Johnston, P. A.: Enhancement of recovery of acute renal failure: effects of mannitol and diuretics. In: Brenner, B. M., Stein, J. M. (eds): Contemporary Issues in Nephrology, Vol. 6. Churchill-Livingstone, New York 1980.

    Google Scholar 

  18. Lieberman, E.: Management of acute renal failure in infants.Nephron, 11, 193 (1973).

    PubMed  CAS  Google Scholar 

  19. Lindner, A.: Synergism of dopamine and furosemide in diuretic-resistant oliguric acute renal failure.Nephron, 33, 121 (1983).

    Article  PubMed  CAS  Google Scholar 

  20. Lucas, A., Meignan, M., Le Gall, J. R., Tillement, J. P., Rapin, M.: Caractéristique pharmacocinétique d’une forte dose de furosémide dans l’insuffisance rénale aiguë.Biomédecine 24, 45 (1976).

    PubMed  CAS  Google Scholar 

  21. Morris, C. R., Alexander, E. A., Bruns, F. J., Levinsky, N. G.: Restoration and maintenance of glomerular filtration by mannitol during hypoperfusion of the kidney.J. Clin. Invest., 51, 1555 (1972).

    Article  PubMed  CAS  Google Scholar 

  22. Mut, R. G.: Frusemide in severe renal insufficiency.Postgrad. Med. J.,47, Suppl. 21 (1971).

    Google Scholar 

  23. Odlind, B., Beermann, B.: Renal tubular secretion and effects of furosemide.Clin. Pharmacol. Ther., 27, 784 (1980).

    Article  PubMed  CAS  Google Scholar 

  24. Prandota, J., Pruitt, A. W.: Furosemide binding to human albumin and plasma of nephrotic children.Clin. Pharmacol. Ther., 17, 159 (1975).

    PubMed  CAS  Google Scholar 

  25. Prandota, J., Witkowska, M.: Pharmacokinetics and metabolism of furosemide in man.Eur. J. Drug Metab. Pharmacokinet., 1, 177 (1976).

    Article  CAS  Google Scholar 

  26. Prandota, J.: Pharmacodynamic determinants of furosemide diuretic effect in children.Dev. Pharmacol. Ther., 9, 88 (1986).

    PubMed  CAS  Google Scholar 

  27. Pruitt, A. W., Boles, A.: Diuretic effect of furosemide in acute glomerulonephritis.J. Pediatr., 89, 306 (1976).

    Article  PubMed  CAS  Google Scholar 

  28. Repetto, H. A., Levy, J. E., Braudo, J. L., Metcoff, J.: The renal functional response to furosemide in children with acute glomerular nephritis.J. Pediatr., 80, 660 (1972).

    Article  PubMed  CAS  Google Scholar 

  29. Retan, J. W., Dillon, H. C.: Furosemide in the treatment of acute post-streptococcal glomerulonephritis.South Med. J., 62, 157 (1969).

    PubMed  CAS  Google Scholar 

  30. Sieniawska, M., Karczenska, J., Korniszewska, J., Wierzbowska-Lange, B.: Methods and results of treatment of acute renal failure in children.Przeg. Pediatr., 9, 467 (1979).

    Google Scholar 

  31. Sieniawska, M., Korniszewska, J., Karczenska, J.: Analysis of clinical course of haemolytic-uraemic syndrome.Przeg. Pediat., 9, 477 (1979).

    Google Scholar 

  32. Tiller, D. J., Mudge, G. H.: Pharmacologic agents used in the management of acute renal failure.Kidney Int., 18, 700 (1980).

    PubMed  CAS  Google Scholar 

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  1. Department of Nephrology, J. Korczak Memorial Children’s Hospital, Wrocław, Poland

    J. Prandota

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Prandota, J. High doses of furosemide in children with acute renal failure. International Urology and Nephrology 23, 383–392 (1991). https://doi.org/10.1007/BF02549611

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