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Disposition and diuretic effect of furosemide in the nephrotic syndrome
Author(s) -
Keller Erich,
HoppeSeyler Georg,
Schollmeyer Peter
Publication year - 1982
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1038/clpt.1982.187
Subject(s) - furosemide , diuretic , volume of distribution , endocrinology , nephrotic syndrome , chemistry , medicine , excretion , pharmacokinetics , urine , renal function , albumin
Plasma levels and diuretic response were determined in seven healthy subjects and six patients with severe nephrotic syndrome (NS) after 40 mg furosemide (Fu). Mean apparent volume of distribution and distribution volume at steady state of the groups did not differ. Total Fu clearance was higher in NS (251 ± 54 ml/min) than in healthy subjects (174 ± 32 ml/min) (P < 0.01), a difference that correlated with the nonrenal clearance of 56 ± 28 ml/min in healthy subjects and 154 ± 45 ml/min in patients with NS (P < 0.001). Normal β‐elimination half‐life of 51 ±7.7 min was 37 ± 6.2 min (P < 0.001) in NS. Mean normal Fu protein binding of 98.6 fell to 97.2%, with decreasing plasma albumin levels. After 40 mg IV Fu, sodium and volume excretion decreased in NS (P < 0.001 and P < 0.005). In patients Na + /Fu excretion rate ratios showed “tubular resistance” to Fu over the time when large amounts of Fu were excreted. The reduced diuretic response to Fu in NS is taken to be mainly a consequence of its impaired renal excretion. Clinical Pharmacology and Therapeutics (1982) 32 , 442–449; doi: 10.1038/clpt.1982.187