Why ESRD patient still take furosemide???

keepmovingrn · Nov 23, 2012

It isn't uncommon for a nephrologist to put a dialysis pt on lasix. They put them on it to remove extra fluid if they still have functioning kidneys. Dialysis does 2 things: remove fluid and waste products. Some pts still urinate more than I do but aren't able to filter out the waste from the blood, so they need dailyisis for the cleaning not fluid.

HTH

Trauma Columnist · Nov 23, 2012

Agree with above. Most PD pts (peritoneal dialysis) pts still produce urine so lasix and maybe even metalazone make sense. However if a pt produces no urine it usually means a provider forgot to do it.

BrandonLPN, LPN · Nov 25, 2012

A doctor once explained to me that even if a pt no longer urinates, lasix can still "shift the the fluids" by shifting fluids out from the lungs. He said anuric pts are sometimes put on lasix to treat pulmonary edema for this reason.

orchunkin · Nov 25, 2012

which mean that if the patient with HD or PD is unneccesary to take Lasix??

moreover, someone said using this drug in this case is to challenge the kidneys to see if there is any renal function left. is it reasonable?

besides, some friend said CHF is easily to get in ESRD patient, this drug is used in this case is to prevent and relieve CHF. is it reasonable?

Take lasix or not should depends on whether the patient have urination or not???

BrandonLPN, LPN · Nov 25, 2012

Not all pts on dialysis are anuric.

keepmovingrn · Nov 25, 2012

Not all pts on dialysis are anuric.

Exactly. Many of my pts urinate more than I do. Seriously.

orchunkin · Nov 25, 2012

moreover, someone said using this drug in this case is to challenge the kidneys to see if there is any renal function left. is it reasonable?

besides, some friend said CHF is easily to get in ESRD patient, this drug is used in this case is to prevent and relieve CHF. is it reasonable?

Take lasix or not should depends on whether the patient have urination or not???

these questions is held after I discussed with my friend

Jennybrie · Nov 25, 2012

It looks like you're still confused how lasix works and asking the same questions over again. If the physician thinks that the pt taking lasix as a benefit to the overall health and there are no adverse effects then I would see no reason not to give a HD/PD lasix. It also pulls potassium out which would be a positive side effect if the pt is hyperkalemic. Look at your pts labs, physical assessment and history to understand the purpose to administer lasix. Making broad assumptions as to why or why not a pt is taking lasix will not help you understand the pts needs.

Esme12, ASN, BSN, RN · Nov 27, 2012

Is this homework? We are happy to help but we need more information? There may be a language barrier that makes the answers here unclear.

In different countries there may be different practices but for the US Lasix is usually NOT given to ESRD patients . There has been some evidence that VERY LARGE (> 500mg) daily has some benefit on edema and weight gain between dialysis treatments. Lasix (Furosimide) is given to AFR (Acute Renal Failure) patients in an attempt to "open up" the kidneys.

Is this what you needed??

nurseprnRN, BSN, RN · Nov 27, 2012

It looks like you're still confused how lasix works and asking the same questions over again. If the physician thinks that the pt taking lasix as a benefit to the overall health and there are no adverse effects then I would see no reason not to give a HD/PD lasix. It also pulls potassium out which would be a positive side effect if the pt is hyperkalemic. Look at your pts labs, physical assessment and history to understand the purpose to administer lasix. Making broad assumptions as to why or why not a pt is taking lasix will not help you understand the pts needs.

Lasix doesn't "pull potassium out" of tissues if there's no functioning renal units. Serum K+ decreases with furosemide (Lasix) because it leaves via the kidneys. No renal function, no serum K+ loss; no serum K+ loss, no cellular K+ loss.

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Get the hard copy, not the online download or the iPad version, because part of the reason it's so good is because it engages different parts of your brain when you use your colored pencils to help you retain the material.

There are no shortcuts for A&P because it's a big part of being a nurse. This is definitely NOT a course you will pass and put out of your head, because after you take it and get into the nursing coursework it will be an integral part of the critical thinking process; your faculty will expect that you remember it. These books will be excellent reference for you when you start seeing real patients. This is unlike any other education you have ever had, trust me. Get the books.

Charslight · May 20, 2015

Since Lasix is a loop diuretic - pulling K+ out of the bloodstream via the kidneys it appears to me that it would not work in an Anuric patient who is on dialysis. However I have found many anuric HD patients still on Lasix and still not sure of the rationale for this. If a hospice patient opts to stop HD - I can't imagine that Lasix would prevent pulmonary edema since that fluid has to go somewhere. If someone isn't urinating - then the K+ would go up - unless they were losing it through their bowels.