Publication: The added-up albumin enhances the diuretic effect of furosemide in patients with hypoalbuminemic chronic kidney disease: a randomized controlled study
Issued Date
2012
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eng
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Mahidol University
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BioMed Central
Bibliographic Citation
BMC Nephrology. Vol. 13, (2012), 92
Suggested Citation
Bunyong Phakdeekitcharoen, Kochawan Boonyawat The added-up albumin enhances the diuretic effect of furosemide in patients with hypoalbuminemic chronic kidney disease: a randomized controlled study. BMC Nephrology. Vol. 13, (2012), 92. doi:10.1186/1471-2369-13-92 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/2692
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Title
The added-up albumin enhances the diuretic effect of furosemide in patients with hypoalbuminemic chronic kidney disease: a randomized controlled study
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Abstract
Background: Chronic kidney disease (CKD) with edema is a common clinical problem resulting from defects
in water and solute excretion. Furosemide is the drug of choice for treatment. In theory, good perfusion
and albumin are required for the furosemide to be secreted at the tubular lumen. Thus, in the situation of
low glomerular filtration rate (GFR) and hypoalbuminemia, the efficacy of furosemide alone might be limited.
There has been no study to validate the effectiveness of the combination of furosemide and albumin in this
condition.
Methods: We conducted a randomized controlled crossover study to compare the efficacy of diuretics
between furosemide alone and the combination of furosemide plus albumin in stable hypoalbuminemic
CKD patients by measuring urine output and sodium. The baseline urine output/sodium at 6 and 24 hours
were recorded. The increment of urine output/sodium after treatment at 6 and 24 hours were calculated by
using post-treatment minus baseline urine output/sodium at the corresponding period.
Results: Twenty-four CKD patients (GFR = 31.0 ± 13.8 mL/min) with hypoalbuminemia (2.98 ± 0.30 g/dL) were
enrolled. At 6 hours, there were significant differences in the increment of urine volume (0.47 ± 0.40 vs 0.67 ± 0.31 L,
P < 0.02) and urine sodium (37.5 ± 29.3 vs 55.0 ± 26.7 mEq, P < 0.01) between treatment with furosemide alone and with
furosemide plus albumin. However, at 24 hours, there were no significant differences in the increment of urine volume
(0.49 ± 0.47 vs 0.59± 0.50 L, P = 0.46) and urine sodium (65.3 ± 47.5 vs 76.1 ± 50.1 mEq, P = 0.32) between the two
groups.
Conclusion: The combination of furosemide and albumin has a superior short-term efficacy over furosemide alone in
enhancing water and sodium diuresis in hypoalbuminemic CKD patients.