Short-Term Furosemide Therapy In Chronic Renal Disease; Implications Of Hypomagnesia And Potential For Improving Hyperkalaemia 91-95
Dr. Arul Amutha Elizabeth Lawrence
Department Of Pharmacology
Sree Balaji Medical College,
No, 7, Work's Road,
Tel : 09444867213
Email Id: firstname.lastname@example.org
Background: Several long term studies on the effect of furosemide in chronic renal diseases exist. Furosemide has been noticed to lead to early electrolyte balance in several long-term studies. Further, some studies have shown that an early, rapid decrease in potassium (K) levels is seen with furosemide therapy.
Objectives and Methods: Hence, a short term study was undertaken to study the potential effect of a short, 3-day therapy with furosemide on chronic renal failure (CRF) and nephrotic syndromes. The study evaluated the clinical implications of a short-term furosemide therapy in terms of electrolyte imbalance, and as to whether a rapid decrease in potassium levels can be achieved and may be potentially used to cure hyperkalaemia. The study included 100 subjects, out of which 50 were CRF patients and the rest had nephrotic syndrome.
Results: A 3-day course of furosemide showed a rapid decrease in potassium (K) and magnesium (Mg) levels in both the groups. However, the response was protective in patients with CRF, who showed higher pretreatment K and Mg levels, but the nephrotic syndrome patients had normal pretreatment levels (K, Mg). The results were suggestive that furosemide led to hypokalaemia and hypomagnesia. Hence, while caution is needed with furosemide, as it has the potential to cause early hypokalaemia/hypomagnesia, on the other hand, it also depicted a potential of treating hyperkalaemia, as was seen in the CRF patients. Further, a simultaneous decrease in Mg levels suggests a need to supplement Mg in patients who were treated with furosemide, because K supplementation is refractory if Mg is not supplemented. This also undermines a need to monitor the Mg levels in the serum (normally not done), which might be as important as the regular monitoring of the sodium, potassium, and calcium levels, as recommended for loop diuretics. Lipid derangements which are seen with early, short-term furosemide treatments, suggest the need for an early monitoring of the lipid profile, which might be adversely affected; even in case of a short therapy with furosemide.
Conclusion: The rapid potential of furosemide for treating hyperkalaemia needs to be reinforced in large-sampled studies.