[No evidence for renal protective effect of loop diuretics for patients having oliguria]

Ugeskr Laeger. 2012 Oct 22;174(43):2617-20.
[Article in Danish]

Abstract

In many intensive care units, loop diuretics are used more or less routinely to achieve a urinary output above 1 ml/kg/h in critically ill patients. We do not in the literature find any basis of this strategy. In contrast, this practice may cause a risk of circulatory instability in the critically ill patient due to large diuresis and volume depletion. There is no evidence so far that the use of loop diuretics has a renal protective effect or any other beneficial impact on the renal function. The use of loop diuretics in oliguric critically ill patients may be harmful. Consequently an individual assessment is required.

Publication types

  • English Abstract

MeSH terms

  • Acute Kidney Injury / drug therapy*
  • Acute Kidney Injury / physiopathology
  • Critical Illness
  • Diuresis / drug effects
  • Evidence-Based Medicine
  • Fluid Therapy / methods
  • Furosemide / adverse effects
  • Furosemide / pharmacology*
  • Furosemide / therapeutic use
  • Humans
  • Intensive Care Units
  • Kidney / drug effects*
  • Oliguria / drug therapy*
  • Oliguria / physiopathology
  • Renal Insufficiency / drug therapy
  • Renal Insufficiency / physiopathology
  • Risk Factors
  • Sodium Potassium Chloride Symporter Inhibitors / adverse effects
  • Sodium Potassium Chloride Symporter Inhibitors / pharmacology*
  • Sodium Potassium Chloride Symporter Inhibitors / therapeutic use

Substances

  • Sodium Potassium Chloride Symporter Inhibitors
  • Furosemide