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has been cited by the following article:

• 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