KMID : 1102220190380010108
|
|
Kidney Research and Clinical Practice 2019 Volume.38 No. 1 p.108 ~ p.115
|
|
Efficacy of triple diuretic treatment in continuous ambulatory peritoneal dialysis patients: A randomized controlled trial
|
|
Witoon Raweewan
Yongsiri Somchai Buranaburidej Prapan Nanna Pacharin
|
|
Abstract
|
|
|
Background: The efficacy of combined diuretic treatment in patients undergoing continuous ambulatory peritoneal dialysis (CAPD) is not known.
Methods: In a single-center, double-blinded, randomized controlled trial, we randomly assigned 51 adult CAPD patients to receive furosemide 1,000 mg/day, hydrochlorothiazide 100 mg/day, and spironolactone 50 mg/day (triple diuretics [TD] group) or furosemide 1,000 mg/day plus placebo (single diuretic [SD] group) for 6 months. The primary outcome was the difference in daily urine output at the 3rd and 6th month of the study compared to baseline (¥ÄUO) between the SD and TD group. Secondary outcomes were urinary sodium (UNa) and potassium (UK) excretion and overhydration (OH) measured by bioimpedance at 3 and 6 months compared to baseline (¥ÄUNa, ¥ÄUK, and ¥ÄOH, respectively) and daily glucose exposure (g/day).
Results: Forty-three of 51 patients completed the 6-month trial. The ¥ÄUO at 3 and 6 months was significantly higher in the TD group compared to the SD group (386.32 ¡¾ 733.92 mL/day vs. -136.25 ¡¾ 629.08 mL/day, P < 0.001, at 3 months; 311.58 ¡¾ 640.31 mL/day vs. 120.00 ¡¾ 624.07 mL/day, P < 0.001, at 6 months) but there was no significant difference in ¥ÄUNa and ¥ÄUK excretion. Hydration status was significantly better in the TD group (¥ÄOH 1.84 ¡¾ 2.27 L vs. 0.44 ¡¾ 1.62 L, P = 0.03, at 3 months; 1.49 ¡¾ 2.82 L vs. -0.48 ¡¾ 2.61 L, P = 0.02, at 6 months). There was no serious adverse event in this study.
Conclusion: For end-stage renal disease patients on CAPD, the combination of furosemide, hydrochlorothiazide, and spironolactone results in higher urine output and better volume control compared to furosemide alone.
|
|
KEYWORD
|
|
Furosemide, Hydration status, Hydrochlorothiazide, Peritoneal dialysis, Spironolactone
|
|
FullTexts / Linksout information
|
|
|
|
Listed journal information
|
|
|
|