FUROSEMIDE-INDUCED PANCREATITIS AND RENAL DYSFUNCTION IN A PATIENT WITH CHRONIC RENALFAILURE

Though the frequency of occurrence is low several drugs can cause pancreatitis which include frequently prescribed drugs such as azathioprine, thiazide diuretics estrogen and tetracy cline. Recently we experienced a case of chronic renal failure in which treatment with furosemide might cause panreatitis and renal dysfunction following gastrectomy. A 71-year-old woman with chronic renal failure underwent subtotal gastrectomy because of gastric cancer of Bormann type 3. On the following day the patient became oliguric and furosemide was administered in an attempt to increase urinary production. There were increases in serum amylase, lipase and creatinine without fever and abdominal pain. Although there was no evidence of biliary tract disease, recent alcohol consumption, hyperlipidemia or hypercalcaemia, she was diagnosed as acute pancreatitis. Conservative treatment for pancreatitis such as fasting and administration of Urinastatin was stated. But serum amylase and lipase not decrease. Since it has been reported that furosemide could be a possible causative agent of pancreatits, this drug was withdrawn. After withdrawal of furosemide there were remarkable decreases in serum amylase, lipase and creatinine. As furosemide is a commonly used drug, it is important to have the association between furosemide and pancreatitis in mind. Patients with renal failure appera to have an increased risk of pancreatic side effects when treated with furosemide, possibly at a high dose.