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Diuretics, Limited Ultrafiltration, and Residual Renal Function in Incident Hemodialysis Patients: A Case Series
Author(s) -
Sjolund Jessica,
Garcia Anton Desiree,
Bayes Liz Y.,
Hoekstra Tiny,
Dekker Friedo W.,
Munoz Mendoza Jair
Publication year - 2016
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/sdi.12508
Subject(s) - medicine , furosemide , renal function , urology , peritoneal dialysis , hemodialysis , creatinine , dialysis , urine , diuretic , ultrafiltration (renal) , chemistry , chromatography
The effect of diuretics on residual renal function expressed as residual GFR ( rGFR ) and urine volume ( rUV ) using 24‐hour urine collections has not been well examined in hemodialysis ( HD ) patients. We present a small (seven patient) but provocative case series describing a strikingly low rate of decline in rUV and rGFR (average of creatinine and urea clearances, 24‐hour urine collections) in patients treated with increasing doses of furosemide (up to 360 mg/day) during the first 2 years after initiation of HD . Between 6 and 12 months, the mean rUV fell by 1 ml/month, whereas rGFR declined by 0.03 ml/min/1.73 m 2 /month. The mean rate of decline from 12 to 24 months for rUV (33 ml/month) and rGFR (0.02 ml/min/1.73 m 2 /month) were also low. While data are clearly limited and the observation retrospective, they are consistent with the better documented benefit of diuretics observed in end‐stage renal disease patients treated with peritoneal dialysis.