Medullary Nephrocalcinosis Associated with Long-term Furosemide Abuse in Adults.
- Author:
Sung Chul CHOI
1
;
Yoon Goo KIM
;
Jung Ho DO
;
Jung Ah KIM
;
Hyeok Jun HAN
;
Hyun Hee LEE
;
Su Jin YOON
;
Young Ki LEE
;
Wooseong HUH
;
Dae Joong KIM
;
Ha Young OH
;
Bohyun KIM
;
Mi Kung KIM
Author Information
1. Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine,Seoul, Korea. ygkim@smc.samsung.co.kr
- Publication Type:Original Article
- Keywords:
Adult;
Computed tomography;
Furosemide;
Nephrocalcinosis;
Ultrasonography
- MeSH:
Adult*;
Atrophy;
Biopsy;
Causality;
Creatinine;
Edema;
Fibrosis;
Furosemide*;
Humans;
Infant;
Kidney;
Nephrocalcinosis*;
Renal Insufficiency;
Ultrasonography;
Weights and Measures
- From:Korean Journal of Nephrology
2001;20(6):1014-1020
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The use of furosemide is well recognized as a predisposing factor to nephrocalcinosis (NC) in infants. Although furosemide is widely used for various clinical settings in adults, the association of furosemide use and nephrocalcinosis in adults is not well established. METHODS: We studied 18 consecutive adult patients(male : female=1 : 17, age range 21-59 years) who took furosemide habitually to control their weights or edema for a long-term period(range 3-25 years). NC was evaluated using renal ultrasonography(US), computed tomography(CT) and/or kidney biopsies. Patients were categorized into NC(+) and NC(-) groups while the difference in clinical features were investigated. RESULTS: Renal US and CT revealed nephrocalcinosis in the bilateral medullary pyramids in 15(83.3 %) out of 18 patients. The duration of furosemide abuse was not different between NC(+) and NC(-) groups(10.1+/-1.7 years vs. 15.3+/-0.9, p>0.05). The daily dose of furosemide was higher in NC(+) group than the NC(-) group(538+/-174 vs. 67+/-13 mg/day, p<0.01), however. All patients showed a variable degree of renal insufficiency and there was no difference in creatinine clearance between two groups(p>0.05). The kidney biopsies performed in three patients showed focal tubulointerstitial fibrosis and atrophy and calcifications were observed at outer medullary tubulointerstitium. CONCLUSION: Long-term furosemide abuse could cause medullary nephrocalcinosis in adults and the risk of developing of nephrocalcinosis is correlated with the daily dose of furosemide. We suggest that long-term furosemide abuse should be suspected in adult patients when medullary nephrocalcinosis is incidentally detected by US and/or CT.
