Nondialytic Management of Chronic Uremia

Abstract

We evaluated salt loading alone and in conjunction with diuretic therapy in the management of chronic renal disease with azotemia. Ten patients with chronic renal disease and azotemia were treated with progressively increasing doses of sodium and potent, distal tubular diuretic agents, ie, furosemide or ethacrynic acid or both. Hydrochlorothiazide was also employed in these patients. Six of the ten patients responded with an adequate diuresis of more than 2,200 ml/24 hr, a fall in blood urea nitrogen level, and an alleviation of uremic symptoms with an average dose of 6 gm of added sodium, on a basal 2-gm sodium diet. In four patients, salt loading was unsuccessful; two of these patients had creatinine clearance values of less than 7 ml/min.