Use of large doses of furosemide in acute renal failure in children
Prandota, J.
Pediatria Polska 62(8): 547-553
1987
ISSN/ISBN: 0031-3939 PMID: 3431965 Document Number: 286490
The diuretic effect of high doses of furosemide with or without mannitol was analysed retrospectively in 30 children with acute renal failure. In the children (group I, mean age 11.3 .+-. 1.4 years) the failure developed during glomerulonephritis, and in 20 children (group II, mean age 1.5 .+-. 1.1 years) the cause was gastroenteritis. The diuretic effect was evaluated measuring the 24-hour urine volume at the time of anuria (urine volume not lower than 30 ml in 24 hours), oliguria, and excretion of greater volumes of urine but with urea and creatinine levels raised by at least 100%. The highest and daily intravenous doses of furosemide in group I were 6.5 and 10.1 mg/kg respectively, and in group II 14 and 25.5 mg/kg respectively. In both groups a statistically significant negative correlation was found between the daily intravenous dose of furosemide and the diuretic effect of the drug. No such correlation was demonstrated for furosemide and mannitol given on the same days. The calculation of the optimal dose of furosemide producing the expected 24-hour diuresis suggest that the daily intravenous dose of furosemide in older and younger children with acute renal failure should not exceed 100 mg. Furosemide was well tolerated. Electrolyte disturbances, including hypokalemia, especially in newborns, were the most frequent side effects of high doses of furosemide.