Uso crônico de baixas doses de Furosemida em pacientes renais crônicos, com função renal residual submetidos à hemodiálise

Abstract

Background: The use of diuretics has been proven effective in patients with chronic renal failure by increasing the volume and urinary sodium excretion, but most studies have been performed using high doses of this drug, acutely. The objective of the present study was to verify whether chronic renal patients on HD with residual diuresis who were using small doses of furosemide present different levels of urinary volume and sodium excretion compared to patients with residual diuresis who do not use this drug. Methods: We studied 19 chronic renal patients on HD who presented any level of residual diuresis. Urine was collected during the 24-hour interdialytic period, and physical examinations and blood drawing for testing took place immediately before the start of HD. Patients were divided into two groups: DG (n=10), in which patients had been using 40 of Furosemide for at least 3 months, and NDG (n=9), in which patients used no diuretics. Results: Although both groups presented the same average glomerular filtration rate (GFR) (p > 0.05) and time in dialysis (p > 0.05,) the DG presented an average of twice the urinary volume in 24 h (1142 ± 184 vs 453 ± 135 ml/24 h, respectively; p= 0.008) and double the total excreted sodium mass (UVNa) compared to patients in the NDG (112 ± 22.4 vs 45.2 ± 16.0 mEq/24 h, respectively; p= 0.02). Conclusion: The results of this study have shown that chronic use of small doses of furosemide in chronic renal patients with residual diuresis could increase urinary volume and sodium excretion compared to patients who did not use this drug.