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Urinary loss of thiamine is increased by low doses of furosemide in healthy volunteers
Year:
1999
Authors :
Ezra, David
;
.
Volume :
134
Co-Authors:
Rieck, J.
Halkin, H., Department of Medicine, Sheba Medical Center, Tel Hashomer 52621, Israel
Almog, S.
Seligman, H.
Lubetsky, A.
Olchovsky, D.
Ezra, D.
Facilitators :
From page:
238
To page:
243
(
Total pages:
6
)
Abstract:
Prolonged furosemide treatment is associated with urinary loss of thiamine and thiamine deficiency in some patients with congestive heart failure and low dietary thiamine intake. In the rat, diuretic-induced thiamine urinary loss is solely dependent on increased diuresis and is unrelated to the type of diuretic used. We studied the effects of single intravenous doses of furosemide (1,3, and 10 mg) and of normal saline infusion (750 mL) on urinary thiamine excretion in 6 volunteers. Over a 6-hour period, furosemide induced dose-dependent increases in urine flow and sodium excretion rates (mean ± SD), from 51 ± 17 mL/h at baseline to 89 ± 29 mL/h, 110 ± 38 mL/h, and 183 ± 58 mL/h (F = 10.4, P < .002) and from 5.1 ± 2.3 mmol/h to 9.4 ± 6.8 mmol/h, 12.1 ± 2.6 mmol/h, and 20.9 ± 10.6 mmol/h (F = 6.3, P < .005) for the three doses, respectively (104 ± 35 mL/h and 13.0 ± 6.2 mmol/h for the saline infusion). During this period the thiamine excretion rate doubled from baseline levels (mean of four 24-hour periods before the diuretic interventions) of 6.4 ± 5.1 nmol/h to 11.6 ± 8.2 nmol/h (F = 5.03, P < .01, for all four interventions, no difference being found between them), then returning over the following 18 hours to 6.1 ± 3.9 nmol/h. The thiamine excretion rate was correlated with the urine flow rate (r = 0.54, P < .001), with no further effect of the type of intervention or sodium excretion rate. These findings complement our previous results in animals and indicate that sustained diuresis of >100 mL/h induces a nonspecific but significant increase in urinary loss of thiamine in human subjects. Thiamine supplements should be considered in patients undergoing sustained diuresis, when dietary deficiency may be present.
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DOI :
10.1016/S0022-2143(99)90203-2
Article number:
Affiliations:
Database:
Scopus
Publication Type:
article
;
.
Language:
English
Editors' remarks:
ID:
24774
Last updated date:
02/03/2022 17:27
Creation date:
17/04/2018 00:09
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Scientific Publication
Urinary loss of thiamine is increased by low doses of furosemide in healthy volunteers
134
Rieck, J.
Halkin, H., Department of Medicine, Sheba Medical Center, Tel Hashomer 52621, Israel
Almog, S.
Seligman, H.
Lubetsky, A.
Olchovsky, D.
Ezra, D.
Urinary loss of thiamine is increased by low doses of furosemide in healthy volunteers
Prolonged furosemide treatment is associated with urinary loss of thiamine and thiamine deficiency in some patients with congestive heart failure and low dietary thiamine intake. In the rat, diuretic-induced thiamine urinary loss is solely dependent on increased diuresis and is unrelated to the type of diuretic used. We studied the effects of single intravenous doses of furosemide (1,3, and 10 mg) and of normal saline infusion (750 mL) on urinary thiamine excretion in 6 volunteers. Over a 6-hour period, furosemide induced dose-dependent increases in urine flow and sodium excretion rates (mean ± SD), from 51 ± 17 mL/h at baseline to 89 ± 29 mL/h, 110 ± 38 mL/h, and 183 ± 58 mL/h (F = 10.4, P < .002) and from 5.1 ± 2.3 mmol/h to 9.4 ± 6.8 mmol/h, 12.1 ± 2.6 mmol/h, and 20.9 ± 10.6 mmol/h (F = 6.3, P < .005) for the three doses, respectively (104 ± 35 mL/h and 13.0 ± 6.2 mmol/h for the saline infusion). During this period the thiamine excretion rate doubled from baseline levels (mean of four 24-hour periods before the diuretic interventions) of 6.4 ± 5.1 nmol/h to 11.6 ± 8.2 nmol/h (F = 5.03, P < .01, for all four interventions, no difference being found between them), then returning over the following 18 hours to 6.1 ± 3.9 nmol/h. The thiamine excretion rate was correlated with the urine flow rate (r = 0.54, P < .001), with no further effect of the type of intervention or sodium excretion rate. These findings complement our previous results in animals and indicate that sustained diuresis of >100 mL/h induces a nonspecific but significant increase in urinary loss of thiamine in human subjects. Thiamine supplements should be considered in patients undergoing sustained diuresis, when dietary deficiency may be present.
Scientific Publication
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