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However, apart from case reports, there is no evidence favoring ENaC blockade in patients with NS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The monocentric randomized controlled AMILOR study investigated the antiedematous effect of amiloride (starting dose 5\u2009mg\/day, max. 15\u2009mg\/day) in comparison to standard therapy with the loop diuretic furosemide (40\u2009mg\/day, max. 120\u2009mg\/day) over 16\u2009days. Overhydration (OH) was measured by bioimpedance spectroscopy (BCM, Fresenius). Depending on the OH response, diuretic dose was adjusted on days 2, 5, 8 and 12, and if necessary, hydrochlorothiazide (HCT) was added from d8 (12.5\u2009mg\/day, max. 25\u2009mg\/day). The primary endpoint was the decrease in OH on d8. The study was terminated prematurely due to insufficient recruitment and a low statistical power due to a low actual effect size.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Median baseline OH was +26.4 (interquartile range 15.5\u201335.1)% extracellular water (ECW) in the amiloride arm and\u2009+\u200927.9 (24.1\u201329.4)% ECW in the furosemide arm and decreased by 1.95 (0.80\u20136.40) and 5.15 (0.90\u20138.30)% ECW after 8\u2009days, respectively, and by 10.10 (1.30\u201314.40) and 7.40 (2.80\u201310.10)% ECW after 16\u2009days, respectively. OH decrease on d8 and d16 was not significantly different between both arms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The AMILOR study is the first randomized controlled pilot study suggesting a similar antiedematous effect as furosemide. Further studies are required to better define the role of amiloride in NS (EudraCT 2019\u2010002607\u201018).<\/jats:p><\/jats:sec>","DOI":"10.1111\/apha.14183","type":"journal-article","created":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T07:04:41Z","timestamp":1717225481000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Amiloride versus furosemide for the treatment of edema in patients with nephrotic syndrome: A pilot study (<scp>AMILOR<\/scp>)"],"prefix":"10.1111","volume":"240","author":[{"given":"Anja","family":"Schork","sequence":"first","affiliation":[{"name":"Division of Diabetology, Endocrinology and Nephrology, Department of Internal Medicine IV University Hospital T\u00fcbingen  T\u00fcbingen Germany"},{"name":"Institute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of T\u00fcbingen  T\u00fcbingen Germany"},{"name":"German Center for Diabetes 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