title: Efficacy of metolazone and furosemide in children with furosemide-resistant edema.
abstract: The effect of a combination of metolazone (0.2 to 0.4 mg/kg/d) and furosemide (2 to 4 mg/kg/d) in achieving a natriuresis and diuresis was measured in 14 children during 22 episodes of edema resistant to furosemide alone. Urinary volume increased from 24 +/- 14 mL/kg/d for patients receiving furosemide to 51 mL/kg/d with combined diuretic therapy (P less than .01), and sodium excretion increased from 34 +/- 5 mEq/d to 155 +/- 176 mEq/d (P less than .01). Two children with severe hypoalbuminemia (serum albumin level less than 1.5 g/dL) and normal renal function, and five children with chronic renal insufficiency (71%) did not respond to combined diuretic therapy. The combination of furosemide and metolazone offers a useful and effective oral therapy in most children with edema resistant to furosemide. Children with chronic renal insufficiency and furosemide-resistant edema did not respond to combination diuretic therapy.
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004231:Diuresis / Q000187:drug effects; D004232:Diuretics / Q000008:administration & dosage*; D004341:Drug Evaluation; D004351:Drug Resistance; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D004487:Edema / Q000188:drug therapy*; D005665:Furosemide / Q000008:administration & dosage* / Q000652:urine; D006801:Humans; D007223:Infant; D007676:Kidney Failure, Chronic / Q000150:complications; D008788:Metolazone / Q000008:administration & dosage* / Q000652:urine; D009318:Natriuresis / Q000187:drug effects; D011188:Potassium / Q000097:blood / Q000652:urine; D012709:Serum Albumin / Q000032:analysis; D012964:Sodium / Q000097:blood / Q000652:urine
chemical_list: D004232:Diuretics; D012709:Serum Albumin; D005665:Furosemide; D012964:Sodium; D011188:Potassium; D008788:Metolazone