Comparison between the effects of torsemide and furosemide on the renin-angiotensin-aldosterone system of normal dogs

J Vet Cardiol. 2019 Dec;26:51-62. doi: 10.1016/j.jvc.2019.11.003. Epub 2019 Nov 14.

Abstract

Introduction/objectives: We hypothesized that torsemide and furosemide, at approximately equipotent dosages (similar diuresis), would have comparable effects on the circulating renin-angiotensin-aldosterone system.

Animals, materials and methods: Six, healthy, middle-aged, male Beagles were randomized to receive torsemide (0.1 mg/kg PO q 12 h), furosemide (2.0 mg/kg PO q 12 h), or placebo for 10 days during three separate periods, separated by a 10-day washout period, in a crossover design. Blood was collected on days 1, 5, and 9 and 24-h urine collection ended on days 2, 6, and 10. After repeated measures analysis and Bonferonni correction, variables with an adjusted p<0.05 were investigated further, using Tukey's method.

Results: Twenty-four-hour urine production differed significantly between the diuretics only on day 10, with torsemide causing a 38% greater diuresis than furosemide. There was, however, no significant difference in average 3-day diuresis. There were no significant differences between diuretics in the 24-h urinary excretion of sodium, chloride, or potassium, though furosemide caused less kaliuresis than torsemide. Serum renin, angiotensin II, and aldosterone and the urine aldosterone-to-creatinine ratio were significantly increased in the diuretic groups, as compared to placebo on days 5/6 and 9/10. There were no significant differences in these values between diuretics. Creatinine and blood urea nitrogen concentrations rose comparably in the diuretic groups, remaining within reference intervals in all dogs.

Conclusions: At approximately equipotent dosages (20:1), torsemide and furosemide produced comparable renin-angiotensin-aldosterone system activation. Torsemide's similar potassium excretion profile to furosemide decreases support for a hypothesized mineralocorticoid-receptor blocking capability.

Keywords: Congestive heart failure; Diuretics; Kaliuresis; Urine aldosterone to creatinine ratio.

Publication types

  • Randomized Controlled Trial, Veterinary

MeSH terms

  • Animals
  • Cross-Over Studies
  • Diuretics / pharmacology
  • Dogs
  • Furosemide / administration & dosage
  • Furosemide / pharmacology*
  • Male
  • Renin-Angiotensin System / drug effects*
  • Torsemide / administration & dosage
  • Torsemide / pharmacology*

Substances

  • Diuretics
  • Furosemide
  • Torsemide