Does albumin enhance the diuretic action of furosemide in nephrotic syndrome?
ASN 30th Annual Meeting, San Antonio
J Am Soc Nephrol (Sep) 8:88A 1997
The effect of albumin on furosemide efficacy was studied in 6 patients with nephrotic syndrome. Furosemide 160 mg IV over 1h was given in either 100 ml of 20% albumin of 5% dextrose in water by random cross-over design. Volume of distribution, urine excretion of furosemide, and 24h urine volumes and excretion of sodium and chloride were not different in the two groups. The authors conclude that albumin infusion did not enhance the diuretic effect of furosemide.
Comment: Studies performed in Japan over a decade ago (Inoue et al) , suggested that a furosemide- albumin infusion (same IV bag) was effective in edematous hypoalbuminemic patients. The mechanism was believed to be a decreased volume of distribution of albumin-bound furosemide and enhanced tubular secretion, leading to increased urinary furosemide concentrations. This abstract does not include data on serum albumin levels. Thus, the negative data in the present report do not exclude the possibility that furosemide-albumin may be effective in selected patients (such as those with severe hypoalbuminemia and diuretic resistance). (David J. Leehey, M.D., Loyola University at Chicago)
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ASN 30th Annual Meeting, San Antonio
Nephrotic Syndrome : Treatment (CEI, indomethacin, lipid drugs)