diuretic (frusemide) therapy causing harm
|
|
| Posted By: | dermot phelan |
| Email: | dphelan@mater.ie |
| URL: | |
| This seems a great site - first time I've visited. congratulations. Re. review of Mehtha(JAMA) paper, there is the call for RCTs to resolve the question of whether diuretics cause harm. I wonder why the previous RCTs on this issue (which support the 'harm' hypothesis) do not get a mention (ever) in this discussion. Are they too old and perhaps not reflective of present practice or too small(most likely) or too focussed on high dose frusemide? I enclose the abstracts: 1: Clin Nephrol 1981 Feb;15(2):90-6 High dose frusemide in acute renal failure: a controlled trial. Brown CB, Ogg CS, Cameron JS. Fifty-eight patients in established acute renal failure following trauma or surgery were allocated in a prospective and random fashion to two different diuretic regimes. In the control group, 1 g frusemide was given as a single injection over four hours. In the test group, frusemide was then continued either intravenously or orally in a dose of 3 g/24 hr until a urine output of 200 ml/hr was sustained or until the plasma creatinine fell below 300 umoles/l. Oliguria was reversed or prevented in 24 of 28 patients given sustained frusemide, but in only 2 patients given a single injection. However, the number of dialyses and duration of renal failure and mortality were not different in the two groups. The serious complication of deafness occurred in two patients and in one of them this was permanent. Publication Types: Clinical Trial Randomized Controlled Trial PMID: 7011622 [PubMed - indexed for MEDLINE] 1: Nephron 1976;17(1):51-8 Related Articles, Links Furosemide in acute oliguric renal failure. A controlled trial. Kleinknecht D, Ganeval D, Gonzalez-Duque LA, Fermanian J. A randomized study was conducted on 66 patients with acute established oliguric renal failure. Intravenous doses of furosemide ranging from 1.5 to 6.0 mg/kg were given every 4 h to 33 of the patients; the remaining 33 patients served as controls. A persisting diuretic response was observed in 5 treated patients and in 2 controls. Hemodialyses were required in most of them. Furosemide did not significantly modify in cured patients the mean oliguric period, the number of dialyses and the mean period of renal insufficiency. Publication Types: · Clinical Trial · Randomized Controlled Trial PMID: 778649 [PubMed - indexed for MEDLINE] Thank you dermot phelan | |
|
Edit this message |
|
 diuretic (frusemide) therapy causing harm By:dermot phelan |
|
|
[ Back ] Any questions or comments please contact gdoig@med.usyd.edu.au Implemented and designed by John Soer and Gordon Doig Page last modified on Wednesday February 8, 2000 |
|
| S P A C E R . . . . . . . . . . . . . . . . . . . . . . . . . . . | |