objective To explore the efficacy of large dose of diuretics in preventing cardiovascular complications in ESRD patients on maintenance hemodialysis. Methods fifty-four ESRD patients, initiating maintenance hemodialysis, with urine volume between 200～500 ml/d were randomly divided into study group and control group. The patients in study group were administered with furosemide 80～160 mg/d or bumetanide 3～4mg/d, excepting dialysis day, and the patients in control group were not administered any diuretics. Beside diuretics, all patients in the two groups received the same integrated treatment schedule including anti-hypertension, controlling water and salt input, treating anemia, etc. The baseline data such as age, primary diseases, pre-study daily urine volume, pre-study blood pressure and pre-study heart-to-chest ratios were not significantly different between tow groups. The observation duration was 12 months and the end-point events were death and congestive heart failure. The mean daily urine volume, mean ultrafiltration volume in each dialysis session, blood pressure, heart-to-chest ratio and the episodes of congestive heart failure were compared between two groups by the end of the study. Results At the end of the study, compared to controls, the further reduction of daily urine volume in study group was significantly less, mean artery pressure and heart-to-chest ratios significantly lower, the incidence of congestive heart failure significantly lower, the reduction of residual renal function retarded, and the incidence of hyperkalemia significantly reduced. No case in study group while 3 controls died. Conclusion It is indicated that the usage of large dose diuretics was profitable in preventing water-sodium retention in ESRD patients on maintenance hemodialysis, better controlling blood pressure, reducing ultrafiltrate needed by the patients, which is effective in reducing the incidence of the cardiovascular complications of the hemodialysis patients. It is suggested that large dose of diuretics might be an economic and effective therapy for ESRD patients on maintenance hemodiapysis patients.
