TITLE:
Sequential Combination Diuretic-Therapy for Massive Fluid Overload in Furosemide-Refractory Patients with Diabetic Kidney Disease
AUTHORS:
Kamel El-Reshaid, Shaikha Al-Bader
KEYWORDS:
Aldactone, Diabetes Mellitus, Echocardiography, Fluid Overload, Furosemide, Hydrochlorothiazide, Kidney Disease, Metolazone, Spironolactone
JOURNAL NAME:
Open Journal of Nephrology,
Vol.11 No.2,
June
7,
2021
ABSTRACT: Patients with renal disease are at risk of fluid overload which escalates as the disease progresses. In the present study, we evaluated the efficacy of sequential combination diuretic-therapy (SCDT) in management of massive fluid overload in Furosemide-refractory renal patients. The added diuretics were Spironolactone 25 mg daily for 3 days, to those without risk of hyperkalemia, followed by Hydrochlorothiazide 25 mg/Metolazone 5 mg daily for 3 more days. Excluded patients were those with 1) acute renal disease, 2) echocardiographic evidence of: a) left ventricular ejection fraction