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Efficacy of Oral High Dose [500mg] Frusemide in the Treatment of Resistant Oedema of Nephrotic Syndrome
Oedema resistant to the usual prescribed dose of 40-120mg frusemide daily has been reported in some cases of Nephrotic Syndrome.
This study investigated the efficacy of oral high dose [500mg] frusemide given once or in divided twice daily dose in 23 Nephrotic Syndrome patients with resistant oedema [<500ml daily urine output on 120mg frusemie].
Their mean age was 33 ± 2.3 years with creatinine clearance of 8.9±1ml/min. Blood pressure and fluid input and output were measured daily. Twice weekly weighing was carried out. Results showed that 14 [60.9%] had a diuretic response with mean input/output of 1227 ± 49ml/2298 ±123 ml respectively and significant weight loss 10 ± 1kg [p<0.05] on average of 7 days administration. 9 [30.1%] did not show response with mean input/output 1012±59/571 ±80ml with no significant change in weight.
They had to be dialysed with ultrafiltration. Both responders and non-responders had significant drop in systolic blood pressure 14 mmHg and 3 mmHg respectively [p<0.05] but no significant drop in diastolic blood pressure. Four of those that had dialysis died. Oral high dose frusemide appeared to be effective in the treatment of resistant oedema of Nephrotic Syndrome.
NQJHM Vol. 14 (1) 2004: pp. 54-55