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Efficacy of metolazone and furosemide in children with furosemide-resistant edema.

Abstract
The effect of a combination of metolazone (0.2 to 0.4 mg/kg/d) and furosemide (2 to 4 mg/kg/d) in achieving a natriuresis and diuresis was measured in 14 children during 22 episodes of edema resistant to furosemide alone. Urinary volume increased from 24 +/- 14 mL/kg/d for patients receiving furosemide to 51 mL/kg/d with combined diuretic therapy (P less than .01), and sodium excretion increased from 34 +/- 5 mEq/d to 155 +/- 176 mEq/d (P less than .01). Two children with severe hypoalbuminemia (serum albumin level less than 1.5 g/dL) and normal renal function, and five children with chronic renal insufficiency (71%) did not respond to combined diuretic therapy. The combination of furosemide and metolazone offers a useful and effective oral therapy in most children with edema resistant to furosemide. Children with chronic renal insufficiency and furosemide-resistant edema did not respond to combination diuretic therapy.
AuthorsW C Arnold
JournalPediatrics (Pediatrics) Vol. 74 Issue 5 Pg. 872-5 (Nov 1984) ISSN: 0031-4005 [Print] United States
PMID6493882 (Publication Type: Comparative Study, Journal Article)
Chemical References
  • Diuretics
  • Serum Albumin
  • Furosemide
  • Sodium
  • Potassium
  • Metolazone
Topics
  • Adolescent
  • Child
  • Child, Preschool
  • Diuresis (drug effects)
  • Diuretics (administration & dosage)
  • Drug Evaluation
  • Drug Resistance
  • Drug Synergism
  • Drug Therapy, Combination
  • Edema (drug therapy)
  • Furosemide (administration & dosage, urine)
  • Humans
  • Infant
  • Kidney Failure, Chronic (complications)
  • Metolazone (administration & dosage, urine)
  • Natriuresis (drug effects)
  • Potassium (blood, urine)
  • Serum Albumin (analysis)
  • Sodium (blood, urine)

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