Patient tolerance of long-term diuretic/potassium supplement therapy

Forty patients with congestive heart failure or hypertensive heart disease were given long-term maintenance treatment with a combined bumetanide/slow-release potassium supplement preparation ('Burinex K'). Stabilised doses ranged from 0.5 mg to 2 mg bumetanide with from 7.7 mmol to 30.8 mmol potassium. Patients took doses either at 9 a.m. or at 5 p.m. daily during a series of alternate 2 to 4-weekly treatment periods. Analysis of patient preference for morning or evening diuresis showed that the majority (72.5%), including all 18 patients who went out to work, preferred the evening regimen. Bumetanide proved to be a highly effective diuretic, irrespective of time of administration. Evening diuresis was associated with a statistically significant increase in the 24-hour excretion of sodium. Serial laboratory analyses showed no clinically significant changes in serum potassium or other parameters examined an in contrast to other diuretics bumetanide produced no significant hyperuricaemic effects.