Shilliday IR, Quinn KJ, Koehler W, Simpson K, Allison MEM
The role of loop diuretics in acute renal failure? A
double-blind, randomised controlled trial
Am Soc Nephrol
J Am Soc Nephrol (abstract)
(Nov) 6:477 1995
96 patients with acute renal failure not reversed by hydration were given
continuous dopamine (2 mg/kg/min); intravenous mannitol every 6 hours for 3
days; and either furosemide 3 mg/kg, torsemide 3 mg/kg, or placebo every 6
hours
for 21 days or until renal recovery. Although urine flow was significantly
increased with either diuretic, renal recovery, need for dialysis and
mortality
were not affected by diuretic use. Six patients in each diuretic group had
seizures and one furosemide patient had temporary deafness. In these
patients,
administration of loop diuretics was not of obvious benefit. This conclusion
held whether patients were analyzed as being nonoliguric, oliguric, or
converting from oliguric to nonoliguric. Comment:
Unfortunately, all patients
received both mannitol and dopamine, neither of which can currently be
recommended. Whether the findings are generalizable to patients not given
dopamine or mannitol can be debated.
(Paller)
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Am Soc Nephrol
Etiologic index :
Reduced circulatory volume/sepsis/hepatorenal
ARF Treatment :
Treatment