Abstract 1620 Poster Session I, Saturday, 5/1 (poster 127)

Furosemide administered on alternate days, rather than daily, may decrease the risk of renal calculi while improving pulmonary function in small, preterm infants. To assess the effects of alternate-day furosemide therapy on known risk factors for stone formation, we performed longitudinal 24-hr urine collections and analyses on 17 infants at 2 and 4 wk of age who were 23-28 wk gestational age and < 1250 g birth weight. Furosemide was being given on alternate days to 7 infants when assessed at 2 wk, and to 8 infants when assessed at 4 wk; the other infants did not receive any furosemide during the week prior to the collection. Urine collections were performed on the day of the furosemide therapy. All data are mean (SE) and are mg/kg/d except for sodium (mEq/kg/d.) (Table) Furosemide treated-infants had significantly greater 24-hr urinary calcium excretion and tended to have lower urinary citrate and greater urinary sodium excretion than untreated infants. Renal ultrasound at 8 wk showed one furosemide-treated infant with renal calculi. We conclude that very high calcium/citrate ratios >1.0 are common in alternate-day furosemide-treated infants, who may be predisposed to stone formation. Therapy to decrease urinary calcium (e.g., thiazide diuretics) while increasing urinary citrate (e.g., potassium citrate) should be considered early in the management of small, preterm infants treated with furosemide.

Table 1 No caption available
Full size table

Funded in part by Abbott Laboratories