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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