Efficacy, Safety, and Tolerability of Oral Furosemide Among Patients Receiving Hemodialysis: A Pilot Study.
Efficacy, Safety, and Tolerability of Oral Furosemide Among Patients Receiving Hemodialysis: A Pilot Study.
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DOI：
10.1016/j.ekir.2022.07.003
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发表时间：
2022-10
影响因子：
6
通讯作者：
Dember, Laura M.
中科院分区：
文献类型：
--
作者：
Flythe, Jennifer E.;Assimon, Magdalene M.;Tugman, Matthew J.;Narendra, Julia H.;Singh, Simran K.;Jin, Wanting;Li, Quefeng;Bansal, Nisha;Hostetter, Thomas H.;Dember, Laura M.
使用利尿剂可减少血液透析中容量相关并发症。我们评估了呋塞米在血液透析依赖性肾衰竭患者中的疗效、安全性和耐受性。我们在接受维持性血液透析的患者中进行了一项开放标签、单组、18周、口服呋塞米（最大剂量320 mg/天）的剂量滴定初步研究，这些患者报告每天至少有1杯尿量。主要疗效结局是从基线增加至24小时尿量的特定阈值，阈值基于基线尿量（<200 ml/天vs. ≥200 ml/天）。安全性结局包括低钾血症和低镁血症，通过预先指定的患者报告症状评估耐受性。在39名参与者中，28名（72%）接受了预期的呋塞米剂量，3名（8%）接受了剂量减少，5名（12%）在没有剂量减少的情况下停用呋塞米，3名（8%）接受了剂量减少，随后停用呋塞米。基线24小时尿量中位数（四分位数1，四分位数3）为290 ml（110，740），研究呋塞米的最大平均日剂量范围为69 mg/d至320 mg/d。在意向治疗分析中，第5、12和18周分别有12（33%）、11（33%）和7（22%）例受试者达到尿量疗效结局，在治疗中分析中，第5、12和18周分别有12（39%）、9（35%）和7（28%）例受试者达到尿量疗效结局。无电解质、呋塞米水平或患者报告的听力变化安全性事件。呋塞米通常是安全的，耐受性良好，但只有三分之一的参与者在第5周符合疗效定义。疗效结果的临床重要性尚不确定。
Diuretic use may reduce volume-related complications in hemodialysis. We evaluated the efficacy, safety, and tolerability of furosemide in patients with hemodialysis-dependent kidney failure. We conducted an open label, single-arm, 18-week, dose titration pilot study of oral furosemide (maximum dose 320 mg/day) among patients receiving maintenance hemodialysis who reported at least 1 cup of urine output per day. The primary efficacy outcome was an increase from baseline to a specified threshold of 24-hour urine volume, with the threshold based on baseline urine volume (<200 ml/day vs. ≥200 ml/day). Safety outcomes included hypokalemia and hypomagnesemia, and tolerability was assessed by prespecified patient-reported symptoms. Of the 39 participants, 28 (72%) received the expected furosemide dose, 3 (8%) underwent dose reduction, 5 (12%) discontinued furosemide without dose reduction, and 3 (8%) underwent dose reduction and subsequently discontinued furosemide. The median (quartile 1, quartile 3) baseline 24-hour urine volume was 290 ml (110, 740), and the maximum, average daily study furosemide dose ranged from 69 mg/day to 320 mg/d. The urine output efficacy outcome was met by 12 (33%), 11 (33%), and 7 (22%) participants at weeks 5, 12, and 18, respectively, in the intention-to-treat analysis, and by 12 (39%), 9 (35%), and 7 (28%) participants at weeks 5, 12, and 18, respectively, in the on-treatment analysis. There were no electrolyte, furosemide level, or patient-reported hearing change safety events. Furosemide was generally safe and well tolerated, but only one-third of participants met the efficacy definition at week 5. The clinical importance of the efficacy findings is uncertain.
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影响因子：
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作者：
Jessen, Annika;Ho, Andrew D.;Shin, Jennifer J.
通讯作者：
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影响因子：
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Moledina, Dennis G.;Wilson, Francis Perry
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作者：
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作者：
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通讯作者：
BRATER, DC
DOI：
10.2215/cjn.07670618
发表时间：
2019-01-07
影响因子：
9.8
作者：
Flythe, Jennifer E.;Hilliard, Tandrea;Mehrotra, Rajnish
通讯作者：
Mehrotra, Rajnish