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Does Furosemide Increase Oxidative Stress in Acute Kidney Injury?
Silbert, Benjamin I; Ho, Kwok M; Lipman, Jeffrey; Roberts, Jason A; Corcoran, Tomas B; Morgan, David J; Pavey, Warren; Mas, Emilie; Barden, Anne E; Mori, Trevor A.
Afiliação
  • Silbert BI; 1 Department of Intensive Care Medicine, Fiona Stanley Hospital , Murdoch, Australia .
  • Ho KM; 2 School of Medicine and Pharmacology, Royal Perth Hospital Unit, University of Western Australia , Perth, Australia .
  • Lipman J; 3 Department of Intensive Care Medicine, Royal Perth Hospital , Perth, Australia .
  • Roberts JA; 4 School of Population Health, University of Western Australia , Crawley, Australia .
  • Corcoran TB; 5 School of Veterinary and Life Sciences, Murdoch University , Murdoch, Australia .
  • Morgan DJ; 6 Burns, Trauma and Critical Care Research Centre, School of Medicine, University of Queensland , Brisbane, Australia .
  • Pavey W; 7 Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital , Herston, Australia .
  • Mas E; 8 Faculty of Health, Queensland University of Technology , Brisbane, Australia .
  • Barden AE; 6 Burns, Trauma and Critical Care Research Centre, School of Medicine, University of Queensland , Brisbane, Australia .
  • Mori TA; 7 Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital , Herston, Australia .
Antioxid Redox Signal ; 26(5): 221-226, 2017 02 10.
Article em En | MEDLINE | ID: mdl-27530232
ABSTRACT
Furosemide, a loop diuretic, is used to increase urine output in patients with acute kidney injury (AKI). It remains uncertain whether the benefits of furosemide in AKI outweigh its potential harms. We investigated if furosemide influenced oxidative stress in 30 critically ill patients with AKI by measuring changes in F2-isoprostanes (F2-IsoPs), markers of in vivo oxidative stress, in plasma and urine following intravenous furosemide. Urine F2-IsoPs were higher in sepsis (p = 0.001) and increased in proportion to urine furosemide (p = 0.001). The furosemide-induced increase in urine F2-IsoPs differed depending on AKI severity (p < 0.001) and was greatest in those with the most severe AKI. Furosemide had no effect on plasma F2-IsoPs. We demonstrate for the first time that furosemide increases renal oxidative stress in AKI and find that patients with the most severe AKI-to whom the largest doses are likely to be administered-showed the greatest increase in oxidative stress. These findings lead to the hypothesis that the common practice of administering high-dose furosemide to convert oliguric to nonoliguric AKI may induce harmful oxidative stress in the kidneys, and an adequately powered, randomized controlled trial is required to determine if clinical benefits of this dosing strategy justify its potential harms. Antioxid. Redox Signal. 26, 221-226.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Estresse Oxidativo / Diuréticos / Injúria Renal Aguda / Furosemida Tipo de estudo: Clinical_trials / Diagnostic_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2017 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Estresse Oxidativo / Diuréticos / Injúria Renal Aguda / Furosemida Tipo de estudo: Clinical_trials / Diagnostic_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2017 Tipo de documento: Article