Effects of low-dose furosemide combined with aminophylline on the renal function in septic shock patients

Abstract

Background

To investigate the effects of low-dose furosemide and aminophylline on the renal function in patients with septic shock.

Methods and Results

A total of 109 eligible septic shock patients in the intensive care unit were randomly divided into a control group (n = 55) and an intervention group (n = 54). The control group received normal saline, and the intervention group received low-dose furosemide (0.048 mg/kg.h⁻¹) with aminophylline (0.3 mg/kg.h⁻¹). The primary outcomes included the levels of serum creatinine (Scr), creatinine clearance rate (Ccr), blood urea nitrogen (BUN), glomerular filtration rate (GFR), and urine output on admission and on days 3, 7 and 14. The secondary outcomes were the sequential organ failure assessment (SOFA) scores, continuous renal replacement therapy (CRRT) time and intensive care unit (ICU) mortality, hospital mortality and 28-day mortality. There were no significant differences in the levels of Scr, Ccr, BUN, or GFR between the two groups, while the urine output was higher in the intervention group on days 3, 7, and 14. Compared with the control group, the SOFA scores, ICU mortality, hospital mortality and 28-day mortality were significantly lower in the intervention group on days 3, 7, and 14, the CRRT time was shorter, and the cumulative fluid balance was lower on days 3 and 7 in the intervention group.

Conclusions

Although low-dose furosemide and aminophylline have fewer protective effects on the renal function in septic shock patients, they could reduce the CRRT time and improve the prognosis.

Keywords:

• Septic shock
• aminophylline
• furosemide
• acute kidney injury
• mortality

Acknowledgments

We would like to express gratitude toward all patients involved in this study.

Ethical approval

This study was approved by ethics committee of Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China (no. 2016-093KT), and written informed consent was obtained from each participant.

Author contributions

Collecting literature: Zhenhua Mai, Zilong Yang, Hongpeng Chen, Shuting Cai, Wangwang Hu; Drawing graphs and tables and Data analysis: Xiaoyan Wang; Writing the article: Zhenhua Mai, Yaying Tan, Yang Zhu; Modifying the article: Fenghua Ding, Liehua Deng. All authors have read and approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

All data generated or analyzed during this study are included in this article and its supplementary information files.

Additional information

Funding

This work was supported by the Guangdong Medical Science and Technology Research Fund [No. A2015366] and a grant from the National Natural Science Foundation of China [No. 81974298]. The authors’ work was supported by the grants from Guangdong Science and Technology Innovation Strategy Special Fund [No. 2020A1111350047 and No. 2020A1111350049].