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      The Effect of Furosemide on Residual Nephrons of the Chronically Diseased Kidney in Man

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      Nephron

      S. Karger AG

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          Abstract

          Clearance studies were performed in 50 patients with varying degrees of stable chronic renal disease and 13 normal subjects in order to determine the effect of intravenous furosemide on residual nephrons of the chronically diseased kidney compared to nephrons within normal kidneys. Expression of data in terms of fractional excretion and excretion rate factored by GFR allows an analysis of furosemide effect as related to nephron population, in addition to an assessment of the absolute effect of this drug in producing a negative sodium, water, and potassium balance. A 0.25 mg/kg dose of furosemide produced virtually the same increment in the excretion rate per 100 ml GFR of sodium, water and potassium in diseased kidneys as in those of normal subjects until the GFR approached 15 ml/min. Thereafter, increments in sodium and water excretion were reduced out of proportion to the reduction in nephron mass, but were restored to a range comparable to normal by a 1 mg/kg dose. Studies in transplant donors before and after nephrectomy suggested that the increase in absolute sodium reabsorption which accompanies an increase in GFR per nephron does not explain the decreased responsiveness to the 0.25 mg/kg dose of furosemide observed in advanced azotemia. Thus, until severe disease supervenes with associated advanced azotemia, residual nephrons of the chronically diseased kidney retain responsiveness to a moderate dose of furosemide. The decrease in responsiveness per nephron observed in the presence of severe disease can be restored to normal levels by a 1 mg/kg dose of furosemide and appears to be more closely related to the presence of advanced azotemia rather than to other variables studied.

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          Author and article information

          Journal
          NEF
          Nephron
          10.1159/issn.1660-8151
          Nephron
          S. Karger AG
          1660-8151
          2235-3186
          1971
          1971
          26 November 2008
          : 8
          : 5
          : 427-439
          Affiliations
          Renal Section, Department of Internal Medicine, University of Wisconsin Medical School, Madison, Wisc.
          Article
          179947 Nephron 1971;8:427–439
          10.1159/000179947
          4943168
          © 1971 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 13
          Categories
          Paper

          Cardiovascular Medicine, Nephrology

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