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| 신증후군 환자에서 알부민 병용 투여가 Furosemide 이뇨 효과에 미치는 약력학 및 약동학적 유용성 평가 (Does Albumin Infusion Enhance the Diuretic Action of Furosemide in NePhrotic Syndrome?) |
| 김도형, 엄재호, 한진석, 김혜영, 오태근, 허우성, 이정상, 장인진, 신상구 (Doe Hyeong Kim, Jae Ho Earm, Jin Suk Han, Hye Young Kim, Tae Geun Oh, Wooseong Huh, Jung Sang Lee, In Jin Jang and Sang Gu Shin) |
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| Abstract |
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There have been controversies on the effect of albumin in treating edema in nephrotic syndrome patients. We evaluated the additive diuretic effect of coadministration of furosernide with albumin in the six patients with nephrotic syndrome. We administered 160mg of furosemide intravenously for 1 hour with 100rnl of 20% albumin or 5% dextrose by random cross-over design. The urine and plasma furosemide concentrations were measured by HPLC. After the administration of furosemide alone, urine volume, urinary excretions of sodium and chloride were increased significantly compared to those of basal state(P<0.05). But, coadministration of furose- mide with albumin did not increase significantly the urine voume(2285+-445ml vs. 3023+-715ml), urinary excretions of sodium(194+-58rnmol/day vs. 282+-85 mmol/day) and chloride(213+- 54mmoVday vs. 286+- 74mmoVday) comparing to those of furosemide only cases. Addition of albumin to furosemide did not sig- nificantly changed pharmacokinetic parameters such as AUC(28.3+-5.5ug/ml hr vs 36.0+-6.7ug/ml hr), total plasma clearance(115+-30mVmin vs 108+-41ml/min), volume of distribution(0.13+-0.02L/kg vs 0.10+- 0.01L/kg), elirnination half life(1.4+-0.3hr vs 1.5+-0.3hr), and urine furosemide excretion(44+-8% vs 43+ 10%). We concluded that albumin infusion did not enhance the diuretic action of furosemide pharmaco-dynamically and pharmacokinetically in patients with nephrotic syndrome. |
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