Does albumin preinfusion potentiate diuretic action of furosemide in patients with nephrotic syndrome?

The aim of this cross-over study was to investigate whether albumin infusio n before furosemide administration could potentiate the diuretic action of furosemide. Seven patients with nephrotic syndrome were given the following infusions in random order on two separate days: 1) a sham solution followe d by 160 mg of furosemide, 2) 100 mL of 20% human albumin followed by 160 m g of furosemide. Urine and serum furosemide concentrations were measured by high-performance liquid chromatography. The increment of urine volume was greater in albumin preinfusion than in furosemide alone. However, the incre ments of sodium and chloride excretions between furosemide alone and albumi n preinfusion were not different. No significant differences in the pharmac okinetic parameters between the two treatments were observed: area under th e concentration-time curve (AUC: 12.7 +/- 2.2 vs 15.1 +/- 4.4 mug/mL (.) hr ), total plasma clearance (253 +/- 41 vs 256 +/- 54 mL/min), volume of dist ribution (341 +/- 34 vs 494 +/- 153 mL/kg), elimination half life (4.0 +/- 1.1 vs 4.6 +/- 0.8 hr), and urine furosemide excretion of the administered amount (16.5 +/- 7.3 vs 7.5 +/- 1.6%). In conclusion, these data show that albumin preinfusion potentiated diuresis, but not natriuresis, of furosemid e without any change in the pharmacokinetics of the agent in patients with nephrotic syndrome.