Conger JD
Interventions in clinical acute renal failure: What are the Data? (REVIEW)

Am J Kidney Dis (Oct) 26:565-576 1995

In this editorial review, Conger has re-examined the published data pertaining to therapeutic interventions to prevent or reduce the severity of acute renal failure (ARF). A formal analysis (eg-meta analysis) was not performed, although criteria for evaluable studies were defined. Conger suggests that the following treatments are based upon reasonable evidence: mannitol prevents ARF in kidney transplantation, diltiazem may prevent ARF in transplantation and dopamine may be beneficial if given early in ARF. ANF and calcium channel blockers might be beneficial in established ARF. There is no strong evidence for beneficial effects of diuretics and no evidence supporting one form of nutritional support over another.

Comment: Although I concur with most of these conclusions, I believe the evidence in support of the use of ANP to improve GFR in patients with ARF needs to be stronger. (Paller)

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