The validity of the sigmoid Emax model and efficiency concept in diuretic studies [letter]

Alván, Gunnar; Hammarlund‐Udenaes, Margareta; Odlind, Bo

doi:10.1111/j.1365-2125.1991.tb05520.x

Cited by 5 publications

(2 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The concept of efficiency can be derived from the sigmoid Ema x model (the Hill equation; [7,10,16,17]). Diuretic efficiency (Elf) can be calculated as:…”

Section: Efficiency Of Furosemidementioning

confidence: 99%

Sensitivity of residual nephrons to high dose furosemide described by diuretic efficiency

Olden¹,

Meyel

Gerlag

1995

Eur J Clin Pharmacol

View full text Add to dashboard Cite

Ten haemodialysis (HD) patients with a median residual creatinine clearance (CLCR) of 1.9 ml.min-1 x 1.73 m-2 (range 0.6-5.3) were treated with oral furosemide (F) 2.0 g. Overall-efficiency (O-E, daily sodium excretion/total urinary F) and total-efficiency (delta-E, increase in daily sodium excretion/total urinary F) were measured on the last 24 hours of each interdialysis interval. In addition, O-E was measured during the complete interdialysis interval in 10 HD patients with a median CLCR of 5.6 ml.min-1 x 1.73 m-2 (range 0.7-6.8) treated for 1 year with a fixed oral dose of F between 250-1000 mg (median 625 mg). In the short study the median O-E was 10.6 mmol.mg-1 (range 1.9-22.0) and delta-E 6.2 mmol.mg-1 (range 1.3-11.2). The fractional excretion of sodium FENa was significantly increased from 9.6% (range 4.1-22.9) to 27% (range 14.6-56.2) during F treatment. A positive correlation was found between the basal FENa and delta-E. In the long-term study median O-E was 6.4 mmol.mg-1. O-E and FENa showed no change over time although median RCC decreased from 5.6 to 1.9 ml.min-1 x 1.73 m-2 and median F excretion from 11.8 to 7.5 mg per day. It can be concluded that diuretic efficiency in haemodialysis patients is dependent on FENa and the state of hydration during the interdialysis interval.

show abstract

“…The concept of efficiency can be derived from the sigmoid Ema x model (the Hill equation; [7,10,16,17]). Diuretic efficiency (Elf) can be calculated as:…”

Section: Efficiency Of Furosemidementioning

confidence: 99%

Sensitivity of residual nephrons to high dose furosemide described by diuretic efficiency

Olden¹,

Meyel

Gerlag

1995

Eur J Clin Pharmacol

View full text Add to dashboard Cite

show abstract

“…Efficiency of Furosemide: The efficiency of a pharmacon is the ratio between the effect per unit of that pharmacon and its concentration at the site of its effect (12,14,(27)(28)(29). The ratio between the total excretion of sodium and that of furosemide was used to calculate the overall diuretic efficiency (12).…”

Section: Calculationsmentioning

confidence: 99%

Acute Effects of High-Dose Furosemide on Residual Renal Function in CAPD Patients

et al. 2003

View full text Add to dashboard Cite

♦ Background High doses of furosemide can increase urine volume in chronic peritoneal dialysis (CAPD) patients. However, no information is available about effects on urinary solute excretion in relation to residual glomerular filtration rate (GFR), urinary furosemide excretion, and peritoneal solute kinetics. ♦ Methods Diuretic response and the effect on peritoneal fluid and solute transport parameters were investigated in 7 stable CAPD patients with residual renal function (median urine volume 350 mL/24 hours, range 140–1900 mL/24 hours). Comparisons were made during two clearance periods of 24 hours: one without (P1) and one during 2 g furosemide (P2). ♦ Results The median increase in urine volume was 400 mL (range 270 – 910 mL, p < 0.02) and the increase in sodium excretion was 54 mmol (range 25 –118 mmol, p < 0.02). No change in GFR was found between P1 (2.4 mL/minute, range 0.6 – 5.7 mL/min) and P2 (2.0 mL/min, range 1.0 – 4.8 mL/min). An increase in fractional clearance was found for volume, sodium, potassium, and osmolality ( p < 0.02). No change was found in the fractional clearance of urea and electrolyte-free water. Furosemide excretion in urine was 8.7 mg/24 hours (range 2.1 – 38 mg/24 hours) and in dialysate 4.9 mg/24 hours (range 1.9 – 7.8 mg/24 hours). Plasma furosemide concentration was 29.5 mg/L (range 6.2 – 43.9 mg/L). A positive correlation was found between residual GFR and total urine furosemide excretion ( r=0.93, p < 0.005). Efficiency, expressed as the increase in fractional sodium clearance (percent) per milligram of furosemide excreted per 24 hours, was 1.2%/mg (range 0.3%–11.3%/mg). ♦ Conclusion High-dose furosemide is effective in CAPD patients in increasing urine volume and electrolyte excretion without affecting urea and creatinine clearance. In CAPD patients, the individual response to an identical high dose of furosemide is dependent on the magnitude of residual GFR.

show abstract

The influence of food intake on the effect of two controlled release formulations of furosemide

Paintaud

Alván

Eckernäs

et al. 1995

Biopharm & Drug Disp

View full text Add to dashboard Cite

Differences in the urinary excretion rate of furosemide may explain discrepancies observed between the bioavailability and the total diuretic effect of different formulations of this drug. Furosemide was given at a dose of 60 mg as two oral controlled release (CR) formulations (FR and LR), with and without breakfast, in a randomized, four-treatment, four-period, crossover design to 28 healthy volunteers. Urinary volume, and contents of furosemide and sodium, were measured in samples taken over 24 h. The extent and rate of absorption of furosemide from FR were decreased after breakfast as compared to fasting: the mean (SD) of total furosemide excreted decreased from 11.38 (3.12) to 7.73 (1.67) mg, p < 0.0001, and the median (range) mean residence time increased from 6.3 (4.1-9.3) to 9.5 (5.9-11.8) h, p < 0.001. On the other hand, the extent of absorption of LR was increased after breakfast, from 8.04 (3.32) to 9.45 (1.83) mg, p < 0.05, without a significant change in MRT. FR had a higher extent and rate of absorption than LR during fasting, but its extent of absorption was lower than that of LR in the postprandial state. Interestingly, the total fraction of furosemide absorbed, as estimated from total furosemide excretion, was not correlated with the total diuresis (r2 = 0.079) and the differences in drug response compared among the four periods were much smaller than would be expected from the differences in amount absorbed. This discrepancy may be explained by differences in urinary excretion rate of furosemide and, related to this, differences in efficiency profiles between the four treatments. Therefore, the urinary excretion profile of a formulation of furosemide may be more important for the cumulated drug effect than the amount absorbed.

show abstract

The validity of the sigmoid Emax model and efficiency concept in diuretic studies [letter]

Cited by 5 publications

References 7 publications

Sensitivity of residual nephrons to high dose furosemide described by diuretic efficiency

Sensitivity of residual nephrons to high dose furosemide described by diuretic efficiency

Acute Effects of High-Dose Furosemide on Residual Renal Function in CAPD Patients

The influence of food intake on the effect of two controlled release formulations of furosemide

Contact Info

Product

Resources

About