1. Measures of Loop Diuretic Efficiency and Prognosis in Chronic Kidney Disease
- Author
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Frederik H. Verbrugge, Pieter Martens, Dirk Kuypers, Bert Bammens, W.H. Wilson Tang, Jeffrey M. Testani, Verbrugge, Frederik Hendrik/0000-0003-0599-9290, VERBRUGGE, Frederik, MARTENS, Pieter, Testani, Jeffrey M., Tang, W. H. Wilson, Kuypers, Dirk, Bammens, Bert, Medicine and Pharmacy academic/administration, Cardiology, and Intensive Care
- Subjects
medicine.medical_specialty ,medicine.drug_class ,Urology ,medicine.medical_treatment ,Natriuresis ,Renal function ,Sodium Potassium Chloride Symporter Inhibitors ,Renal Dialysis ,medicine ,Humans ,Urine specimen collection ,Renal replacement therapy ,Mortality ,Renal Insufficiency, Chronic ,Dialysis ,Retrospective Studies ,Heart Failure ,business.industry ,Acute kidney injury ,Furosemide ,Loop diuretic ,Prognosis ,medicine.disease ,Chronic renal insufficiency ,Nephrology ,Diuretic ,Cardiology and Cardiovascular Medicine ,business ,Kidney disease ,medicine.drug - Abstract
Background: The evolution and prognostic impact of loop diuretic efficiency according to chronic kidney disease (CKD) severity is unclear. Methods: This retrospective cohort study includes 783 CKD patients on oral loop diuretic therapy with a 24-h urine collection available. Acute kidney injury and history of renal replacement therapy were exclusion criteria. Patients were stratified according to Kidney Disease Improving Global Outcomes (KDIGO) glomerular filtration rate class. Loop diuretic efficiency was calculated as urine output, natriuresis, and chloruresis, each adjusted for loop diuretic dose, and compared among strata. Risk for onset of dialysis and all-cause mortality was evaluated. Results: Loop diuretic efficiency metrics decreased from KDIGO class IIIB to IV in furosemide users and from KDIGO class IV to V with all loop diuretics (p value ρ 0.298–0.436; p value Conclusion: Low loop diuretic efficiency is independently associated with a shorter time to dialysis initiation and a higher risk for all-cause mortality in CKD.
- Published
- 2020
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