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Effect of Furosemide on Obesity-induced Glomerular Hyperfiltration

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00962286
Recruitment Status : Terminated (The blood pressure did not decrease following furosemide administration)
First Posted : August 19, 2009
Last Update Posted : August 4, 2011
Information provided by:
Rabin Medical Center

Brief Summary:

Background: Obesity is associated with a high prevalence of chronic kidney disease. The glomerular hyperfiltration associated with obesity may play a role in the pathogenesis of obesity associated chronic kidney disease. Attenuation of hyperfiltration by pharmacological means may slow down the development and progression of chronic renal failure. The investigators have previously shown that acetazolamide, a proximally acting diuretic that activates TGF by increasing solute delivery to the macula densa, abates glomerular hyperfiltration. The present study was designed to test the hypothesis that this decrease in hyperfiltration is specific to acetazolamide and not due to a non specific diuretic effect. The aim of the present study is to evaluate the effects of the administration of furosemide p.o. to subjects with severe obesity on glomerular hemodynamics.

Methods: Ten obese subjects will participate in the study. They will undergo measurement of glomerular filtration rate (inulin clearance) (GFR), renal plasma flow (RPF) (p-aminohippuric acid clearance), filtration fraction, fractional excretion of lithium (FE LI) and blood pressure, before and after administration of oral furosemide 20 to 40 mg bid for 3 days. The effects of furosemide on glomerular hemodynamics in obese subjects will be compared to the previously studied effects of acetazolamide.

Condition or disease Intervention/treatment Phase
Obesity-induced Hyperfiltration Drug: Furosemide Not Applicable

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 3 participants
Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Study Start Date : September 2009
Actual Primary Completion Date : May 2010
Actual Study Completion Date : July 2010

Resource links provided by the National Library of Medicine

Drug Information available for: Furosemide

Arm Intervention/treatment
Experimental: Furosemide, obesity, glomerular hyperfiltration Drug: Furosemide

Subjects will receive 300 mg of lithium carbonate at 22.00 the day before the renal function tests.Intravenous catheters will be placed in each upper limb for infusion of clearance markers and blood sampling.A priming dose of inulin (50 mg/kg) and p-aminohippuric acid (8 mg/kg) will be administered. Thereafter, inulin and p-aminohippuric acid will be infused continuously. A 200-300 ml water load will be given during the first 60-min prime.

Subjects will be started on furosemide p.o. 20 mg every 12 hours, starting on day 1 at 15.00 after the renal function studies. Nine doses will be taken, the last dose on day 4 at 7 am.

In case the blood pressure does not decrease following 20 mg bid furosemide administration, the study will be repeated after 4 weeks using a dose of 40 mg p.o. bid.

Primary Outcome Measures :
  1. change in GFR [ Time Frame: 3 days ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 55 Years   (Adult)
Sexes Eligible for Study:   Male
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • 10 obese men (BMI>30), aged 18 to 55, with glomerular hyperfiltration (creatinine clearance>130 ml/min) will be included in the study.

Exclusion Criteria:

  • Any of the following conditions:

    • Heart failure
    • Known allergy to furosemide, inulin or amino-hippurate
    • Pharmacologic treatment for hypertension, cardiac disease, diabetes mellitus
    • Treatment with corticosteroids or NSAID

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00962286

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Rabin Medical Center
Petach Tikva, Israel
Sponsors and Collaborators
Rabin Medical Center
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Principal Investigator: Boris Zingerman, MD Rabin Medical Center
1. Chagnac A et al: Glomerular hemodynamics in severe obesity. Am J Physiol Renal Physiol. 2000;278(5):F817-22. 2. Chagnac A et al: The effects of weight loss on renal function in patients with severe obesity. J Am Soc Nephrol. 2003 Jun;14(6):1480-6. 3. Navar LG: Renal autoregulation: perspectives from whole kidney and single nephron studies. Am J Physiol. 1978 May;234(5):F357-70. 4. Deng A etal: Hemodynamics of early tubuloglomerular feedback resetting during reduced proximal reabsorption. Kidney Int. 2002 Dec;62(6):2136-43. 5. Dupont AG et al: Renal pharmacodynamic effects of torasemide and furosemide in normal man.Drug Res. 38(1) 1a 1998 172-175.

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Responsible Party: Boris Zingerman, MD, Rabin Medical Center Identifier: NCT00962286    
Other Study ID Numbers: OBEFUR
First Posted: August 19, 2009    Key Record Dates
Last Update Posted: August 4, 2011
Last Verified: August 2009
Keywords provided by Rabin Medical Center:
Additional relevant MeSH terms:
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Nutrition Disorders
Body Weight
Natriuretic Agents
Physiological Effects of Drugs
Sodium Potassium Chloride Symporter Inhibitors
Membrane Transport Modulators
Molecular Mechanisms of Pharmacological Action