Increasing the dose of furosemide in patients with azotemia and suspected obstruction
| Autor: | Andrew Taylor, Angela Hunsche, Hejung Press |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Urology Diuresis urologic and male genital diseases Drug Administration Schedule Technetium Tc 99m Mertiatide chemistry.chemical_compound Furosemide medicine Loop of Henle Humans Radiology Nuclear Medicine and imaging Intensive care medicine Diuretics Aged Uremia Creatinine medicine.diagnostic_test Dose-Response Relationship Drug business.industry Radioisotope renography General Medicine medicine.disease Image Enhancement medicine.anatomical_structure Treatment Outcome chemistry Azotemia Diuretic Radiopharmaceuticals business Radioisotope Renography medicine.drug Ureteral Obstruction |
| Zdroj: | Clinical nuclear medicine. 29(3) |
| ISSN: | 0363-9762 |
| Popis: | Diuresis renography is widely used to distinguish obstructed from nonobstructed kidneys; however, the delivery of furosemide to its site of action in the loop of Henle is impaired in patients with azotemia. Consequently, the standard adult dose of 40 mg furosemide could be insufficient to generate an adequate diuretic response. This problem is illustrated by a patient with azotemia with bilateral nephrostomies who underwent Tc-99m MAG3 (mercaptoacetyltriglycine) diuresis renography with 40 mg furosemide to determine if his bilateral ureteral obstruction had resolved. The study showed findings typical for obstruction despite the fact that the patient could not have been obstructed because the nephrostomy tubes had not been clamped. When the study was repeated 6 days later with 80 mg furosemide and clamped nephrostomy tubes, there was good drainage bilaterally excluding obstruction. The nephrostomy tubes were removed and the patient's creatinine has subsequently remained stable for 3 years. In summary, this report illustrates the rationale for increasing the dose of furosemide in patients with azotemia referred for diuresis renography and shows how increasing the dose of furosemide could improve the diuretic response and minimize false-positive or indeterminate results. |
| Databáze: | OpenAIRE |
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