Document Detail

Effect of furosemide on left ventricular mass in non-dialysis chronic kidney disease patients: a randomized controlled trial.
MedLine Citation:
PMID:  20876366     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: In chronic kidney disease (CKD), loop diuretics correct volume-dependent hypertension, but their effect on left ventricular mass index (LVMI) is unknown.
METHODS: Forty hypertensive CKD patients (estimated creatinine clearance 60-15 mL/min/1.73 m&sup2;), treated with renin-angiotensin system (RAS) inhibitors, were randomized to receive furosemide or non-diuretic antihypertensive treatment (control group). Office blood pressure (BP) < 130/80 mmHg was pursued in both groups. Primary end point was the reduction of LVMI after 52 weeks. Secondary aims were to verify safety related to furosemide treatment and its effects on ambulatory and clinic BP and body fluid volumes.
RESULTS: Office BP similarly declined in the furosemide group (from 161 ± 14/80 ± 10 to 139 ± 14/74 ± 8 mmHg) and in controls (from 159 ± 16/81 ± 10 to 137 ± 16/75 ± 10 mmHg). We detected a greater reduction (P = 0.013) of LVMI in patients receiving furosemide (- 7.9, IQR from - 15.8 to - 1.4 g/h(2.7)) than in controls (0.0, IQR from - 6.2 to + 9.5 g/h(2.7), P = 0.013). Bio-impedance analysis-derived extracellular water (ECW) significantly decreased in furosemide-treated patients (from 18.7 ± 3.9 to 17.7 ± 3.3 L) while remained unchanged in the control group (from 19.5 ± 2.2 to 19.6 ± 1.9 L). Absolute change of LVMI correlated with changes of ECW in furosemide-treated patients (r = 0.458, P = 0.042) but not in controls. In the furosemide group, no patient experienced side effects requiring drug withdrawal. Conclusions. In hypertensive CKD patients treated with RAS inhibitors, add-on furosemide efficaciously reduces LVMI independently from BP changes. The effect is possibly mediated by better control of volume expansion.
Pasquale Zamboli; Luca De Nicola; Roberto Minutolo; Paolo Chiodini; Marina Crivaro; Sergio Tassinario; Vincenzo Bellizzi; Giuseppe Conte
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Publication Detail:
Type:  Journal Article     Date:  2010-09-27
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  26     ISSN:  1460-2385     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-05-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  1575-83     Citation Subset:  IM    
Correspondence and offprint requests to: Roberto Minutolo; E-mail:
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