Normal Urine Output On Lasix

Prevention of contrast nephropathy by... [JACC Cardiovasc Interv. 2012] - PubMed

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Source

Centro Cardiologico Monzino, IRCCS, Department of Cardiovascular Sciences, University of Milan, Milan, Italy. giancarlo.marenzi@ccfm.it

Abstract

OBJECTIVES: This study investigated the effect of furosemide-forced diuresis and intravenous saline infusion matched with urine output, using a novel dedicated device designed for contrast-induced nephropathy (CIN) prevention.

BACKGROUND:

CIN is a frequent cause of acute kidney injury associated with increased morbidity and mortality.

METHODS:

A total of 170 consecutive patients with chronic kidney disease (CKD) undergoing coronary procedures were randomized to either furosemide with matched hydration (FMH group, n = 87) or to standard intravenous isotonic saline hydration (control group; n = 83). The FMH group received an initial 250-ml intravenous bolus of normal saline over 30 min followed by an intravenous bolus (0.5 mg/kg) of furosemide. Hydration infusion rate was automatically adjusted to precisely replace the patient's urine output. When a urine output rate >300 ml/h was obtained, patients underwent the coronary procedure. Matched fluid replacement was maintained during the procedure and for 4 h post-treatment. The definition of CIN was a ≥25% or ≥0.5 mg/dl rise in serum creatinine over baseline.

RESULTS:

In the FMH group, no device- or therapy-related complications were observed. Four (4.6%) patients in the FMH group developed CIN versus 15 (18%) controls (p = 0.005). A lower incidence of cumulative in-hospital clinical complications was also observed in FMH-treated patients than in controls (8% vs. 18%; p = 0.052).

CONCLUSIONS:

In patients with CKD undergoing coronary procedures, furosemide-induced high urine output with matched hydration significantly reduces the risk of CIN and may be associated with improved in-hospital outcome. (Induced Diuresis With Matched Hydration Compared to Standard Hydration for Contrast Induced Nephropathy Prevention [MYTHOS]; NCT00702728).

Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Source: www.ncbi.nlm.nih.gov

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A difficult problem

It is difficult to treat lymphedema, a problem for many people after leg surgery. Th edema not only is uncomftorable for many of my patients, but also puts them at risk for infections and poor healing.
The only treatments I am aware of, and encourage my patients are to keep their weight down, try to wear the stocking(S) faithfully, exercise to contract the muscles of the leg, keep salt reduced, and elevate the leg when neccessary.
Lasix is sometimes used but only a short term fix and like all medications can have other side effects.
The do may pneumatic compression stockings which we use to use at the hospital years ago

Adequate magnesium in most diets  — Chicago Sun-Times
If you eat whole-grain bread and your tap water is “hard” — meaning it contains relatively high levels of minerals — you probably consume more magnesium than a person who favors white bread and drinks “soft” water.

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