Furosemide Use in Chronic Kidney Disease Patients

Abstract

Chronic kidney disease is defined as kidney disease occurring for more than three months and is characterized by a decreasing glomerular filtration rate, reaching below 60 mL/min/1.73 m2 . Decreased kidney function can reduce the kidney’s capacity to excrete sodium. Excess extracellular fluid will cause hypertension, and lower and upper extremity edema. Loop diuretics, such as furosemide, are known to increase sodium excretion by 20%, thereby reducing the amount of extracellular fluid. This study aimed to determine the patterns of furosemide use in chronic kidney disease patients at University of Muhammadiyah Malang General Hospital. Observational, descriptive, and retrospective data collection methods were used. The use of a single furosemide pattern was given to 25 patients (40%); a two-combination to 12 patients (20%); a three-combination to 9 patients (15%); a four-combination to 12 patients (20%); and a five-combination to 4 patients (5%). The most commonly used single furosemide was furosemide (3 x 40 mg, intravenous [iv]), which was administered to 16 patients (73%); the most common two-combination was furosemide (3 x 40 mg, iv) + amlodipine (1 x 10 mg, oral), which was given to 2 patients (20%); the most common three-combination was furosemide (3 x 40 mg, iv) + candesartan (1 x 16 mg, oral) + amlodipine (1 x 5 mg) and furosemide (3 x 40 mg, iv) + candesartan (1 x 16 mg, oral) + amlodipine (1 x 10 mg, oral), which was given to 2 patients (23%); the most common four-combination was furosemide (3 x 40 mg, iv) + nifedipine (3 x 10 mg, oral) + clonidine (3 x 0.15 mg, oral) + captopril (2 x 25 mg, oral), which was given to 3 patients (28%); and the most common five-combination was given to 1 patient (25%) with 4 patterns. In short, there were 22 patterns of furosemide switch therapy.
 Keywords: furosemide, edema, chronic kidney disease