Role of High-Dose Intravenous Frusemide Therapy in the Management of Chronic Renal Failure

The results of using high doses of intravenous frusemide in the management of 28 patients suffering from chronic renal failure are presented. The results are compared with those obtained from 14 patients also suffering from chronic renal failure, who received identical ‘conservative management’ but were not treated with diuretics. Large doses of intravenous frusemide produced a satisfactory diuretic response in a higher percentage of treated patients (71%) compared with controls (36%). It was also observed that in the treated group of patients a significant diuretic response could be obtained in patients with a creatinine clearance below 4 ml per minute. The study also demonstrated that in the group of patients receiving frusemide the response was better in those who were given a progressive-dose regime; 88% of patients improved with this regime compared with 68% of patients who were treated with a fixed dose of frusemide. Transient deafness with tinnitus and vertigo were the only side-effects observed. However these effects were only seen in patients who received 1000 mg or more frusemide in one day, administered over a period of one to two hours. It is concluded that all patients suffering from chronic renal failure should be given a trial of large doses of intravenous frusemide therapy, along with other conventional measures, particularly where facilities for dialysis are not immediately available.

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Incidence of side-effects associated with high-dose ferric gluconate in patients with severe chronic renal failure

Nephrology ◽

10.1046/j.1440-1797.2003.00118.x ◽

2003 ◽

Vol 8 (1) ◽

pp. 8-10 ◽

Cited By ~ 9

Author(s):

BAHAR BASTANI ◽

ANIL JAIN ◽

GOPAL PANDURANGAN

Keyword(s):

Renal Failure ◽

Chronic Renal Failure ◽

Side Effects ◽

High Dose

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The incidence of side effects associated with high dose ferric gluconate (ferrlecit™) in patients with severe chronic renal failure (CRF)

American Journal of Kidney Diseases ◽

10.1016/s0272-6386(01)80154-2 ◽

2001 ◽

Vol 37 (4) ◽

pp. A12 ◽

Cited By ~ 1

Keyword(s):

Renal Failure ◽

Chronic Renal Failure ◽

Side Effects ◽

High Dose

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Variations in the Lipid Profile of Patients with Chronic Renal Failure, Treated with Folic Acid

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831.73.3.215 ◽

2003 ◽

Vol 73 (3) ◽

pp. 215-220 ◽

Cited By ~ 1

Author(s):

de Gómez Dumm ◽

Giammona ◽

Touceda

Keyword(s):

Renal Failure ◽

Folic Acid ◽

Chronic Renal Failure ◽

Density Lipoprotein ◽

Plasma Homocysteine ◽

Lipid Profiles ◽

Erythrocyte Membranes ◽

Favorable Effect ◽

High Dose ◽

Acid Therapy

Dyslipidemia and increases in plasma homocysteine usually occur at end-stage renal disease; both are recognized as risk factors for atherosclerosis. Folate administration reduces homocysteine concentration. In this study we determined the effect of a high dose of folic acid (40 mg intravenous injection three times a week) on plasma and red blood cell lipid profiles in twelve chronic renal failure patients on regular hemodialysis. Fasting blood samples were taken at the beginning of the study (baseline) and after 21, 42, and 64 days of treatment. Folic acid supplementation decreased plasma homocysteine. Plasma triglyceride levels decreased whereas polyunsaturated fatty acid values increased after 21 days; then they returned to baseline levels at the end of treatment. Total cholesterol and low-density lipoprotein (LDL) cholesterol were higher than those of the baseline during all the study, whereas high-density lipoprotein (HDL) cholesterol was reduced. In erythrocyte membranes, folic acid therapy enhanced cholesterol/phospholipid ratios and the fluorescence anisotropy of diphenyl-hexatriene. We conclude that large doses of folic acid produce a favorable effect, reducing plasma homocysteine levels and protecting patients from atherosclerosis. However, as this therapy induces significant alterations in both plasma and erythrocyte membrane lipid profiles, plasma lipid values should be controlled throughout the treatment of patients with renal failure.

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Current Nanocarrier Strategies Improve Vitamin B12 Pharmacokinetics, Ameliorate Patients’ Lives, and Reduce Costs

Nanomaterials ◽

10.3390/nano11030743 ◽

2021 ◽

Vol 11 (3) ◽

pp. 743

Author(s):

Marco Fidaleo ◽

Stefano Tacconi ◽

Carolina Sbarigia ◽

Daniele Passeri ◽

Marco Rossi ◽

...

Keyword(s):

Side Effects ◽

Vitamin B12 ◽

Memory Performance ◽

Oral Route ◽

High Dose ◽

Human Beings ◽

Inborn Errors ◽

Essential Nutrient

Vitamin B12 (VitB12) is a naturally occurring compound produced by microorganisms and an essential nutrient for humans. Several papers highlight the role of VitB12 deficiency in bone and heart health, depression, memory performance, fertility, embryo development, and cancer, while VitB12 treatment is crucial for survival in inborn errors of VitB12 metabolism. VitB12 is administrated through intramuscular injection, thus impacting the patients’ lifestyle, although it is known that oral administration may meet the specific requirement even in the case of malabsorption. Furthermore, the high-dose injection of VitB12 does not ensure a constant dosage, while the oral route allows only 1.2% of the vitamin to be absorbed in human beings. Nanocarriers are promising nanotechnology that can enable therapies to be improved, reducing side effects. Today, nanocarrier strategies applied at VitB12 delivery are at the initial phase and aim to simplify administration, reduce costs, improve pharmacokinetics, and ameliorate the quality of patients’ lives. The safety of nanotechnologies is still under investigation and few treatments involving nanocarriers have been approved, so far. Here, we highlight the role of VitB12 in human metabolism and diseases, and the issues linked to its molecule properties, and discuss how nanocarriers can improve the therapy and supplementation of the vitamin and reduce possible side effects and limits.

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