Possible Interaction: Albumin and Furosemide

“In conclusion, these data show that albumin preinfusion potentiated diuresis, but not natriuresis, of furosemide without any change in the pharmacokinetics of the agent in patients with nephrotic syndrome.”

“We … of albumin potentiates … frusemide in patients with the nephrotic syndrome.1 We selected 12 inpatients with the nephrotic syndrome according to two criteria: (a) failure to … rest and a 40 mmol sodium diet and (b) presence of minimal lesions or a well preserved glomerular histology on renal biopsy.”

“The binding percentage of furosemide to albumin was approximately 70% in UPA.”

“ Injected furosemide bound to albumin markedly promoted diuresis in NAR, while the same dose of albumin alone had no effect, indicating that binding to albumin is essential for the delivery of furosemide to the kidney, the site for its action.”

“It seems that adding albumin for furosemide pharmacotherapy regime is not recommended as an intervention to increase furosemide efficacy in critically ill hypoalbuminemia patients.”

“At 6 hours, there were significant differences in the increment of urine volume (0.47 ± 0.40 vs 0.67 ± 0.31 L, P < …) and urine sodium (37.5 ± 29.3 vs 55.0 ± 26.7 mEq, P < 0.01) between treatment with furosemide alone and with furosemide … albumin.”

“ConclusionThe combination of furosemide and albumin has a superior short-term efficacy over furosemide alone in enhancing water and sodium diuresis in hypoalbuminemic CKD patients.”

“Co-administration of albumin and furosemide increased the urine volume and sodium level, which is due to increase in the GFR as well as the diuretic effects of furosemide.”

“… albumin … furosemide were 742 mL (SD = 528), 1707 mL (SD = 745) and 2175 mL (SD = 971), respectively (P = 0.015); the fractional excretion of sodium was …; while the glomerular filtration rate (GFR) was 104.5, 96.6 and 106.6 (P = 0.021), respectively, in the three therapy groups.”

“ Albumin mixed with furosemide can promote diuresis and sodium excretion in patients with hypoalbuminemia.”

“In patients with CCr < or = 20 ml/min, albumin mixed with 60 mg FU has a superior diuretic effect compared with FFP mixed with FU.”

“Patients receiving albumin and furosemide had improved weight loss, oxygenation, and hemodynamics.”

“The results clearly show that the addition of albumin to furosemide increases oxygenation (PaO2/FiO2), serum total protein levels, and net fluid loss.”

“A significant correlation was found between the unbound fraction of furosemide and the plasma concentration of albumin.”