Therapeutic Research

Abstract

Objective：This study compared renal actions of carperitide, furosemide and their combination in patients with symptomatic heart failure.Methods：Thirty nine patients were randomly allocated to 3 groups. The first group consisted of 14 patients receiving 20 mg of intravenous furosemide, the second group 10 patients receiving 25 ng／kg／min of continuous infusion of carperitide, and the third group 15 patients receiving their combined administration with the same doses of carperitide and furosemide. Urinary sodium excretion, creatinine clearance and fractional excretion of sodium for 24 hours were assessed. Results：Continuous infusion of carperitide did not cause a significant change of urinary sodium excretion（148±80 versus 139±83 mmol／gCre, p＞0.1）with a significant decrease in urine volume（903±269 versus 1266±396 mL／day, p＜0.05）, compared with intravenous furosemide. Combined administration significantly increased urine volume （1318±384 mL／day）compared with continuous infusion of carperitide alone（p＜0.05）but not with intravenous furosemide alone（p＞0.1）, and significantly promoted urinary sodium excretion（266±132 mmol／gCre）compared with either carperitide or furosemide alone（p＜0.05, respectively）. Combined administration also significantly enhanced fractional excretion of sodium from 1.3±0.7 and 1.3±0.7 to 2.1±0.9％ compared with administration of carperitide alone and furosemide alone（p＜0.05, respectively）. These effects were evident at all levels of creatinine clearance（94 to 8 with a mean of 40±22 mL／min）.Conclusions：Therefore, the combination therapy of carperitide and furosemide promotes natriuresis during treatment for heart failure in patients with various renal functions.