Laboratory Investigation

Kidney International (1975) 8, 362–367; doi:10.1038/ki.1975.128

Effects of furosemide on low-dose mercuric chloride acute renal failure in the rat

Robert C Ufferman1, John R Jaenike1, Richard B Freeman1, Rufino C Pabico1 and with the technical assistance of Craig D Dickstein1

1Nephrology Unit, Department of Medicine, University of Rochester Medical Center, Rochester, New York

Correspondence: Dr Robert C Ufferman, Department of Medicine, University of Rochester, 260 Crittenden Blvd., Rochester, New Yorrk 14642, U.S.A.

Received 12 December 1974; Revised 8 August 1975.

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Abstract

Effects of furosemide on low-dose mercuric chloride acute renal failure in the rat. The use of potent diuretics in acute renal failure remains controversial. Both beneficial and detrimental effects have been reported. In the present study, the effects of both low and high doses of furosemide administered in the developmental and established stages of mercuric chloride-induced acute renal failure were evaluated. Both low and high doses of furosemide produced a significant diuresis when given early in the course of experimental acute renal failure. Despite this diuresis, furosemide did not modify the development of the acute renal failure. Continued administration of a low dose of furosemide had no effect on renal function; however, prolonged administration of high doses of furosemide resulted in significantly lower creatinine clearances 48 hr after induction of acute renal failure. This detrimental effect was due to sodium depletion by the diuretic since it was prevented by continuous replacement of urinary sodium losses. In the absence of sodium depletion, high doses of furosemide produced a significant diuresis, both in the developmental and established phases of acute renal failure, but it had no effect on the degree of renal functional impairment.

Effets de la furosémide sur l'insuffisance rénale aiguë du rat induite par des doses faibles de chlorure mercurique. L'emploi de diurétiques puissants dans l'insuffisance rénale aiguë demeure discuté. Dans ce travail ont été étudiés les effets de doses faibles et de doses importantes de furosémide administrées soit précocément, au stade d'installation, soit plus tardivement au cours de l'insuffisance rénale due au chlorure mercurique. Les doses faibles aussi bien que les doses élevées produisent une diurèse significative quand elles sont administrées tôt au cours de l'insuffisance rénale expérimentale. Malgré cette diurèse, la furosémide ne modifie pas le développement de l'insuffisance rénale. L'administration continue de faibles doses de furosémide n'a pas d'effet sur la fonction rénale alors que l'administration prolongée de fortes doses de furosémide aboutit à des clearences de la créatinine significativement inférieures 48 heures après l'induction de l'insuffisance rénale. Cet effet néfaste est du à la déplétion en sodium déterminée par le diurétique et il disparait quand les pertes urinaires de sodium sont systématiquement compensées. En l'absence de déplétion en sodium, des doses importantes de furosémide produisent une diurèse significative, à la fois au stade précoce de l'insuffisance rénale aiguë et après son établissement, mais elles n'ont pas d'effet sur le degré d'altération de la fonction rénale.

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References

  1. Merrill JP: Acute renal failure, chapter 17 in Diseases of the Kidney (2nd ed), edited by Strauss MB, Welt LE, Boston, Little Brown and Company, 1971, p. 652
  2. Franklin SS, Maxwell MH: Acute renal failure, chapter 19 in Clinical Disorders of Fluid and Electrolyte Metabolism (2nd ed), edited by Maxwell H, Kleeman CR, New York, McGraw-Hill Book Company Inc, 1972, p. 739
  3. Kjellstrand CM: Ethacrynic acid in acute tubular necrosis. Nephron 9:337–348, 1972
  4. Levin NW: Furosemide and ethacrynic acid in renal insufficiency. Med Clin North Am 55:107–119, 1971
  5. Merrill JP: Acute renal failure. JAMA 211:289–291, 1970
  6. Auger RE, Dayton DA, Harrison CE, Tucker RM, Anderson CF: Use of ethacrynic acid in mannitol-resistent oliguric renal failure. JAMA 206:891–893, 1968
  7. Foord RD: Cephaloridine and the kidney, in Progress in Antimicrobial and Anticancer Chemotherapy. Proceedings of 6th International Congress of Chemotherapy, Tokyo, 1969, vol. 1, pp. 597–604
  8. Dodds ME, Foord RD: Enhancement by potent diuretics of renal tubular necrosis induced by cephaloridine. Br J Pharmacol 40:227–236, 1970
  9. Lawson DH, Macadam RF, Singh H, Gavras H, Linton AL: The nephrotoxicity of cephaloridine. Postgrad Med J 46 (suppl):36–39, 1970
  10. Lawson DH, Macadam RF, Singh H, Gavras H, Hartz S, Turnbull D, Linton AL: Effect of furosemide on antibiotic-induced renal damage in rats. J Infect Dis 126:593–600, 1972
  11. Cantarovich F, Ferandez JC, Locatelli A, Perez Loredo J: Furosemide in high doses in the treatment of acute renal failure. Postgrad Med J 47 (suppl):13–17, 1971
  12. Cantarovich F, Galli C, Benedetti L, Chena C, Castro L, Correa C, Perez Loredo J, Ferandez C, Locatelli A, Tizado J: High dose furosemide in established acute renal failure. Br Med J 2:449–450, 1973
  13. Fries D, Pozet N, Dubois N, Traiger J: The use of large doses of furosemide in acute renal failure. Postgrad Med J 47 (suppl):18–20, 1971
  14. Linton AL, Bailey RR, Natale R, Turnbull DI, Craswell PWT: Protective effect of furosemide in acute tubularnecrosis and acute renal failure, in Proc Conf on Acute Renal Failure, May 18–19, 1973, edited by Friedman A, Eliahou HE, Brooklyn, New York, 1973, p. 77
  15. Skeggs T: An automatic method for colorimetric analysis. Am J Clin Pathol 28:311–322, 1957
  16. Marsh WH, Fingerhut B, Kirsch E: Determination of urea nitrogen with diacetyl method and an automatic dialyzling apparatus. Am J Clin Pathol 28:681–688, 1957
  17. Montoreano R, Cunarro J, Mouzet MT, Ruiz-Guinazu A: Prevention of the initial oliguria of acute renal failure by the administration of furosemide. Postgrad Med J 47 (suppl):7–10, 1971
  18. Muth RG: Furosemide in acute renal failure, in Proc Conf on Acute Renal Failure, May 18–19, 1973, edited by Friedman A, Eliahou HE, Brooklyn, New York, 1973, pp. 245–263
  19. Schroder K, Gessler U: The influence of mannitol, ethacrynic acid and furosemide on glomerular filtration in experimental acute renal failure. Postgrad Med J 47 (suppl):11–12, 1971
  20. Flamenbaum W, McDonald FD, DiBona GF, Oken DE: Micropuncture study of renal tubular factors in low dose mercury poisoning. Nephron 8:221–234, 1971 | PubMed | ISI | ChemPort |
  21. Bank N, Mutz BF, Aynedjian HS: The role of "leakage" of tubular fluid in anuria due to mercury poisoning. J Clin Invest 46:695–704, 1967
  22. Hook JB, Blatt AH, Brody MJ, Williamson HE: Effects of several saluretic-diuretic agents on renal hemodynamics. J Pharmacol Exp Ther 154:667–673, 1966
  23. Ludens JH, Hook JB, Brody MJ, Williamson HE: Enhancement of blood flow by furosemide. J Pharmacol Exp Ther 163:456–460, 1968
  24. Birtch AE, Zakheim RM, Jones LG, Barger AC: Redistribution of renal blood flow produced by furosemide and ethacrynic acid. Circ Res 21:869–878, 1967
  25. Bailey RR, Natale R, Turnbull DI, Linton AL: Protective effect of furosemide in acute tubular necrosis and acute renal failure. Clin Sci Mol Med 45:1–17, 1973

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