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Original communication| Volume 79, ISSUE 5, P549-554, May 1976

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Renal hemodynamic response to furosemide in septic and injured patients

DOI:https://doi.org/10.5555/uri:pii:0039606076903627
Renal hemodynamic response to furosemide in septic and injured patients
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      Abstract

      Furosemide frequently is advocated as a prophylaxis against renal failure in septic and injured patients; this effect is thought to be secondary to an increase in renal blood flow. This postulate was tested within 72 hours of admission in 22 previously healthy patients with acute pancreatitis (two), massive trauma (ten), or severe sepsis (ten). Renal clearances of inulin (GFR), para-amino hippurate (ERPF), sodium (CNA), osmoles (Cogsm), and free water (CH2o) were measured in milliliters per minute before and after the intravenous infusion of furosemide (0.5 mg. per kilogram of body weight). Renal vein PAH levels (EPAH) in eight patients were used to calculate true renal plasma flow (TRPF), true renal blood f ow (TRBF), and renal vascular resistance (RVR). Furosernide caused a significant increase in urine volume, CNa, and Cogsm; there were no significant changes in GFR, ERPF, RVR, TRBF, and EPAH. These findings also were observed when the patients were subgrouped according to elevated, normal, or low renal plasma flow and elevated renal vascular resistance. No significant changes were seen in EPAH, thus making a redistribution of renal blood flow unlikely. These studies indicate that furosemide has only a diuretic effect and no hemodynamic effect in the kidney; it has the potential of seriously reducing the circulatory volume and causing renal failure in critical patients.
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      References

        • Bailey R.R.
        • Natale R.
        • Turnbull D.I.
        Protective effect of furosemide in acute tubular necrosis and acute renal failure.
        Clin. Sci. 1973; 45: 1
        • Birth A.G.
        • Zakheim R.M.
        • Jones L.G.
        • et al.
        Redistribution of renal blood flow produced by furosemide and ethacrynic acid.
        Circ. Res. 1967; 21: 869
        • Brown J.J.
        • Gleadle R.I.
        • Lawson D.H.
        • et al.
        Renin and acute renal failure: Studies in man.
        Br. Med. J. 1970; 253
        • Flamenbaum W.
        Pathophysiology of acute renal failure.
        Arch. Intern. Med. 1973; 131: 911
        • Hayes D.F.
        • Werner M.H.
        • Rosenberg I.K.
        • et al.
        Effects of traumatic hypovolemic shock on renal function.
        J. Surg. Res. 1974; 16: 490
        • Ledgerwood A.M.
        • Lucas C.E.
        Postresuscitation hypertension: Etiology, morbidity and treatment.
        Arch. Surg. 1974; 108: 531
        • Liben O.M.
        • Jones S.G.
        • Mueller C.B.
        Mechanism of mannitol diuresis.
        Surg. Gynecol. Obstet. 1963; 117: 211
        • Linton A.L.
        Acute renal failure.
        Canad. Med. Assoc. J. 1974; 110: 949
        • London R.E.
        • Burton J.R.
        Post-traumatic renal failure in military personnel in Southeast Asia.
        Am. J. Med. 1972; 53: 137
        • Lucas C.E.
        • Rector R.E.
        • Werner M.
        • et al.
        Altered renal homeostasis with acute sepsis: A clinical significance.
        Arch. Surg. 1973; 106: 444
        • Ludens J.H.
        • Hook J.B.
        • Brody M.J.
        • et al.
        Enhancement of renal blood flow by furosemide.
        J. Pharmacol. Exp. Ther. 1968; 163: 456
        • Morelli O.H.
        • Moledo L.I.
        • Alanis E.
        • et al.
        Acute effects of high doses in patients with chronic renal failure.
        Postgrad. Med. J. April Suppl. 1971; : 29
        • Ochoa E.
        • Finkielman S.
        • Agrest A.
        Angiotension blood levels during the evolution of acute renal failure.
        Clin. Sci. 1970; 38: 225
        • Ray 111, J.F.
        • Winemiller R.H.
        • Parker J.P.
        • et al.
        Postoperative renal failure in the 1970's: A continuing challenge.
        Arch. Surg. 1974; 108: 576
        • Rosenberg I.K.
        • Gupta S.L.
        • Lucas C.E.
        • et al.
        Renal insufficiency after trauma and sepsis: A prospective functional and ultrastructural analysis.
        Arch. Surg. 1971; 103: 175
        • Smith H.W.
        Principles of renal physiology.
        Oxford University Press, New York1956
        • Stahl W.M.
        • Stone A.M.
        Prophylactic diuresis with ethacrynic acid for prevention of postoperative renal failure.
        Ann. Surg. 1970; 172: 361
        • Stott R.B.
        • Cameron J.S.
        • Ogg C.S.
        • et al.
        Why the persistently high mortality rate in acute renal failure?.
        Lancet. 1972; 2: 75
        • Stone A.M.
        • Stahl W.M.
        Effect of ethacrynic acid and furosemide on renal function in hypovolemia.
        Ann. Surg. 1971; 174: 1
        • Whelton A.
        • Donadio J.W.
        Post-traumatic acute renal failure in Vietnam: A comparison with Korean War experience.
        John Hopkins Med. J. 1969; 124: 95

      Article info

      Publication history

      Accepted: November 7, 1975

      Footnotes

      ☆Supported by the Detroit General Hospital Research Corporation.

      Identification

      DOI: https://doi.org/10.5555/uri:pii:0039606076903627

      Copyright

      © 1976 Published by Elsevier Inc.

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