Ten haemodialysis (HD) patients with a median residual creatinine clearance (CL
CR) of 1.9 ml·min
–1·1.73 m
–2 (range 0.6–5.3) were treated with oral furosemide (F) 2.0 g. Overall-efficiency (O-E, daily sodium excretion/total urinary F) and total-efficiency (
-E, increase in daily sodium excretion/total urinary F) were measured on the last 24 hours of each interdialysis interval. In addition, O-E was measured during the complete interdialysis interval in 10 HD patients with a median CL
CR of 5.6 ml·min
–1·1.73 m
–2 (range 0.7–6.8) treated for 1 year with a fixed oral dose of F between 250–1000 mg (median 625 mg).
In the short study the median O-E was 10.6 mmol·mg
–1 (range 1.9–22.0) and
-E 6.2 mmol·mg
–1 (range 1.3–11.2). The fractional excretion of sodium FE
Na was significantly increased from 9.6% (range 4.1–22.9) to 27% (range 14.6–56.2) during F treatment. A positive correlation was found between the basal FE
Na and
-E. In the long-term study median O-E was 6.4 mmol·mg
–1. O-E and FE
Na showed no change over time although median RCC decreased from 5.6 to 1.9 ml·min
–1·1.73 m
–2 and median F excretion from 11.8 to 7.5 mg per day.
It can be concluded that diuretic efficiency in haemodialysis patients is dependent on FENa and the state of hydration during the interdialysis interval.
Key words Furosemide - Haemodialysis - creatinine clearance - renal excretion - diuretic efficiency