Diuretic Properties of Furosemide in Renal Disease

During the past several years, we have studied a total of 41 patients during 52 courses of oral and intravenous furosemide therapy. All patients had renal disease and significant renal insufficiency, and most were refractory to the standard diuretic agents. The diuretic response to furosemide was complete in 89% of the oral therapy courses and significant but incomplete in the remaining 11%. In the intravenous therapy group, diuresis was complete in 70%, incomplete in 10%, and no diuresis occurred in 20%. Unlike the standard diuretic agents, furosemide is effective over a wide range of arterial pH and serum electrolyte abnormalities. It is effective in hypoalbuminemia and, most signficantly, in the presence of serious reduction of the glomerular filtration rate. Urinary water and electrolyte excretion patterns with furosemide are extremely satisfactory. This saluretic agent is essentially free from toxicity even with very high doses over prolonged periods of time, and unlike thiazides it does not alter carbohydrate metabolism.