ABSTRACTS PRESENTADOS AL 11th INTERNATIONAL SYMPOSIUM "RADIONUCLIDES IN NEPHRO-UROLOGY", REALIZADO EN MONTEREY, CALIFORNIA, 13-17 MAYO 2001.

Aline Sergent-Alaoui`, Georges Deschenes and Michel Wioland*

Médecine Nucléaire Pédiatrique, Hopital Armand-Trousseau, Paris, France.
*Service de Néphrologie

The last consensus on diuresis renography held in Santa Fe in May 1995 recommended direct IV injection of furosemide at a dosage of 1 mg/kg in infants, 0,5 mg/kg in children aged 1-16 year and 40 mg in adults.

Ototoxicity and deafness have been described, as adverse effects of furosemide, mostly associated with high blood concentrations resulting from:

- direct IV injection : a rate limited to 4 mg/min is advocated in adults but no precise recommendation is available for infants and children.

- delayed excretion in patients with impaired renal function:

The immaturity of the renal function in neonates and infants is well established. The glomerular filtration rate rises from 35 ml/min/1,73 m2 at birth to 45 ml/min/1,73 m2 at 3 weeks, 80 ml/min/1,73 m2 at 8 weeks. This maturation is slower in premature, resulting in higher drug toxicity by longer drug half life, specially for loop diuretics.

In conclusion we recommend:

- to infuse furosemide slowly at a rate limited to a maximum of 4 mg/min. No modification of the value of the diuresis renography test has been observed.

- to reduce the dosage of furosemide to 0,3 mg/kg with a maximum amount of 20 mg in elder children.

- to avoid the use of furosemide in neonate and premature.