Diuretics, Limited Ultrafiltration, and Residual Renal Function in Incident Hemodialysis Patients: A Case Series

Semin Dial. 2016 Sep;29(5):410-5. doi: 10.1111/sdi.12508. Epub 2016 May 6.


The effect of diuretics on residual renal function expressed as residual GFR (rGFR) and urine volume (rUV) using 24-hour urine collections has not been well examined in hemodialysis (HD) patients. We present a small (seven patient) but provocative case series describing a strikingly low rate of decline in rUV and rGFR (average of creatinine and urea clearances, 24-hour urine collections) in patients treated with increasing doses of furosemide (up to 360 mg/day) during the first 2 years after initiation of HD. Between 6 and 12 months, the mean rUV fell by 1 ml/month, whereas rGFR declined by 0.03 ml/min/1.73 m(2) /month. The mean rate of decline from 12 to 24 months for rUV (33 ml/month) and rGFR (0.02 ml/min/1.73 m(2) /month) were also low. While data are clearly limited and the observation retrospective, they are consistent with the better documented benefit of diuretics observed in end-stage renal disease patients treated with peritoneal dialysis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Diuretics / therapeutic use*
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Kidney / physiology
  • Kidney Failure, Chronic
  • Male
  • Middle Aged
  • Renal Dialysis*
  • Retrospective Studies
  • Ultrafiltration*


  • Diuretics