Background: High doses of furosemide can increase urine volume in chronic peritoneal dialysis (CAPD) patients. However, no information is available about effects on urinary solute excretion in relation to residual glomerular filtration rate (GFR), urinary furosemide excretion, and peritoneal solute kinetics.
Methods: Diuretic response and the effect on peritoneal fluid and solute transport parameters were investigated in 7 stable CAPD patients with residual renal function (median urine volume 350 mL/24 hours, range 140- 1900 mL/24 hours). Comparisons were made during two clearance periods of 24 hours: one without (P1) and one during 2 g furosemide (P2).
Results: The median increase in urine volume was 400 mL (range 270 - 910 mL, p < 0.02) and the increase in sodium excretion was 54 mmol (range 25 - 118 mmol, p < 0.02). No change in GFR was found between P1 (2.4 mL/ minute, range 0.6 - 5.7 mL/min) and P2 (2.0 mL/min, range 1.0 - 4.8 mL/min). An increase in fractional clearance was found for volume, sodium, potassium, and osmolality (p < 0.02). No change was found in the fractional clearance of urea and electrolyte-free water. Furosemide excretion in urine was 8.7 mg/24 hours (range 2.1 - 38 mg/24 hours) and in dialysate 4.9 mg/24 hours (range 1.9 - 7.8 mg/ 24 hours). Plasma furosemide concentration was 29.5 mg/L (range 6.2 - 43.9 mg/L). A positive correlation was found between residual GFR and total urine furosemide excretion (r = 0.93, p < 0.005). Efficiency, expressed as the increase in fractional sodium clearance (percent) per milligram of furosemide excreted per 24 hours, was 1.2%/mg (range 0.3% - 11.3%/mg).
Conclusion: High-dose furosemide is effective in CAPD patients in increasing urine volume and electrolyte excretion without affecting urea and creatinine clearance. In CAPD patients, the individual response to an identical high dose of furosemide is dependent on the magnitude of residual GFR.
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BMC Nephrol
January 2025
Division of Nephrology, Department of Internal Medicine, Faculty of Health Sciences, University of the Free State, 205 Nelson Mandela Drive, Bloemfontein, 9300, South Africa.
Background: Continuous ambulatory peritoneal dialysis (CAPD) is one of the kidney replacement therapy (KRT) modalities used in patients with kidney failure. It is the preferred modality in most resource-limited settings as it is more accessible and cost-effective. CAPD technique failure remains a challenge and is associated with an increased risk of morbidity and mortality.
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King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
Delirium, a neuropsychiatric syndrome characterized by acute disruptions in attention and awareness, significantly impacts children in Pediatric Intensive Care Units (PICUs), leading to prolonged hospitalization, increased infection risk, and dependence on mechanical ventilation. Despite growing recognition, its true burden and risk factors in children remain poorly understood. This prospective cohort study investigated the prevalence, characteristics, and potential therapeutic targets for delirium in 890 children admitted to a tertiary PICU between January and December 2022.
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Department of Internal Medicine, Wuhan University Hospital Wuhan 430071, Hubei, China.
Objective: To investigate the risk factors for peritonitis in peritoneal dialysis patients and to develop and validate a predictive model.
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Department of Pediatric Neurology, Cerrahpasa Medicine Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey.
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Hospital Infection Control Center, Oita University Hospital, Oita, Japan.
Methylobacterium populi is a fastidious, pink-pigmented, Gram-negative bacterium that has been isolated from poplar trees that are found throughout the Northern Hemisphere in both temperate and subtropical regions. Herein, we report a novel case of M. populi peritonitis associated with continuous ambulatory peritoneal dialysis (CAPD).
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