Abstract
Summary: This study was designed to determine the calciuretic effect of furosemide and its impact upon calcium balance during chronic (25 days) furosemide administration to growing rats. Experiments were performed on 18 six-wk-old rats. Nine animals received furosemide, and 9 served as controls. The administration of furosemide in a dose of 40 mg resulted in a significant increase in calcium excretion in the treated group; urinary calcium excretion almost doubled that of the controls during the first 24-hr collection (3.74 ± 0.44 mg in the treated animals compared with 1.90 ± 0.15 mg in the controls; P < 0.05). The average daily urinary calcium excretion during each of four subsequent 6-day periods remained approximately three-fold higher in animals which received furosemide compared with controls (P < 0.001 for each 6-day period). The furosemide-induced increase in urinary calcium excretion did not diminish with time. Sodium excretion did not significantly increase either acutely or chronically in response to furosemide. Daily urinary volume increased approximately 40 to 60% in the furosemide-treated group compared with that of the controls (P < 0.001). The cumulative calcium balance in the control group exceeded by 7% that of the furosemide-treated animals (2696.3 ± 20.8 mg versus 2518.6 ± 20.1 mg (P ±.001).
The findings indicate that distal nephron compensatory mechanisms effecting sodium conservation following furosemide do not result in similar conservation of calcium. Calcium balance may be deleteriously affected.
Speculation: The long-term effects of furosemide on calcium homeostasis in man are not known. This study in rats suggests that furosemide may have deleterious effects on calcium homeostasis. Similar effects in humans, particularly growing children, may result in decreased calcium balance and bone demineralization.
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Warshaw, B., Anand, S., Kerian, A. et al. The Effect of Chronic Furosemide Administration on Urinary Calcium Excretion and Calcium Balance in Growing Rats. Pediatr Res 14, 1118–1121 (1980). https://doi.org/10.1203/00006450-198010000-00006
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DOI: https://doi.org/10.1203/00006450-198010000-00006
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