Comparison between long-acting and short-acting loop diuretics in patients with chronic kidney disease: evaluation of efficacy and safety

Patients with chronic kidney disease (CKD) were treated with a long-acting loop diuretic, Azosemide and a short-acting loop diuretic, Furosemide in a crossover fashion. The two drugs were compared after crossover switch using a multicenter study design focusing on evaluation of diuretic effects and symptoms associated with quality of life. There was no significant difference between Azosemide and Furosemide treatment after crossover switch in alleviation of edema, blood pressure, and body weight, or change in daily urinary volume or sodium excretion. On the other hand, change in urinary protein excretion from start to end of treatment was less in Azosemide treatment (-0.239g/day) than in Furosemide treatment (0.353g/day) after crossover switch (p=0.0556). In a questionnaire survey of symptoms after treatment, the percentage of patients complaining of “hand cramp” was higher after Azosemide than after Furosemide treatment; however this difference was not statistically significant (p=0.0935). When asked “Which drug do you wish to continue?”, 30% selected Furosemide, 35% selected Azosemide and 35% gave a neutral answer. In conclusion, Azosemide was similar to Furosemide in efficacy and tolerability. (