title: Torasemide for diuretic treatment of advanced chronic renal failure.
abstract: In a double-blind randomized clinical trial the efficacy and safety of oral high-dose torasemide (1-isopropyl-3- ([4-(3-methyl-phenylamino)pyridine]-3-sulfonyl)urea, T) therapy was compared with that of furosemide (F) in 10 patients with advanced chronic renal failure. The efficacy on edema, fluid and electrolyte balance including the influence on renin-angiotensin-aldosterone system and cochlear function was evaluated. Patients were randomly allocated to either 500 mg F/d (group 1) or 200 mg T/d (group 2). After 14 days of treatment doses were doubled in each group for further 14 days. With respect to the 2.5 times lower dose of T the clinical effect of both drugs on edema, fluid and sodium excretion was equipotent. Significant differences were noted on calciuresis. Serum calcium levels were reduced with F, while T had no influence on calcium balance. A significant increase in plasma renin activity (PRA) was observed after F, whereas T had no raising effect on PRA. No significant alteration of plasma aldosterone concentration occurred with T or F. No adverse effects were noted in both groups. Serial audiometries showed no significant impairment of cochlear function with both drugs. In conclusion, these results indicate that high-dose T is efficient and safe in the treatment of advanced chronic renal failure. The lack of a calciuric effect with T can be regarded as an advantage in patients with hypocalcemia in chronic renal failure.
authors.affiliation: Department of Internal Medicine II, Rheinisch-Westfälische Technische Hochschule Aachen, Fed. Rep. of Germany.
authors.forename: W
authors.initials: W
authors.lastname: Clasen
authors.forename: T
authors.initials: T
authors.lastname: Khartabil
authors.forename: S
authors.initials: S
authors.lastname: Imm
authors.forename: J
authors.initials: J
authors.lastname: Kindler
mesh_terms: D000328:Adult; D002118:Calcium / Q000652:urine; D002986:Clinical Trials as Topic; D003051:Cochlea / Q000187:drug effects; D004231:Diuresis / Q000187:drug effects; D004232:Diuretics / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009318:Natriuresis / Q000187:drug effects; D011897:Random Allocation; D012084:Renin-Angiotensin System / Q000187:drug effects; D013449:Sulfonamides / Q000627:therapeutic use*; D000077786:Torsemide
chemical_list: D004232:Diuretics; D013449:Sulfonamides; D002118:Calcium; D000077786:Torsemide