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Paul G. G. Gerlag, MD, PhD; Joseph J. M. van Meijel, MD

Arch Intern Med. 1988;148(2):286-291.

Abstract
• Thirty-five patients with severe chronic congestive heart failure that was refractory to conventional therapy were given high dosages of furosemide (250 to 4000 mg/d) because of significantly reduced renal function (mean endogenous creatinine clearance, 0.53 mL/s/1.73 m² [32 mL/min/1.73 m²]). Natriuresis, weight reduction (mean, 11 kg), and relief of symptoms were achieved in all patients. The mean survival after the start of the high-dose furosemide therapy was 11.3 months (range, 0.5 to 36 months) (n = 35). When this therapy eventually failed, long-term intermittent hemofiltration was performed in eight selected cases, further prolonging survival (mean, 3.0 months). High-dose furosemide therapy and hemofiltration improved the quality of life and prolonged survival. The use of diuretics in congestive heart failure should therefore include treatment with high-dose furosemide, which is effective and can be given over a long period without serious side effects.

(Arch Intern Med 1988;148:286-291)

Author Affiliations
From the Department of Internal Medicine, St Joseph Hospital, Eindhoven, the Netherlands.

Footnotes
Accepted for publication Aug 31, 1987.

Reprint requests to St Joseph Hospital, Aalsterweg 259, 5600 ML Eindhoven, the Netherlands (Dr Gerlag).

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