Examining Mannitol Use in Kidney Cancer Surgery: A Cautionary Tale of Extrapolated Surgical Data

Eur Urol Focus. 2019 Nov;5(6):930-934. doi: 10.1016/j.euf.2019.09.021. Epub 2019 Oct 15.

Abstract

Mannitol for renal protection during partial nephrectomy is common but unsupported by evidence from clinical trials. The impact of mannitol on renal physiology includes both beneficial and harmful effects. Current understanding of renal ischemia reperfusion injury suggests potentially targetable processes that have a lower potential risk.

MeSH terms

  • Acute Kidney Injury / physiopathology
  • Acute Kidney Injury / prevention & control
  • Cardiovascular Diseases / complications
  • Cardiovascular Diseases / mortality
  • Case-Control Studies
  • Clinical Trials as Topic
  • Diuretics, Osmotic / adverse effects
  • Diuretics, Osmotic / pharmacology*
  • Diuretics, Osmotic / toxicity
  • Glomerular Filtration Rate / drug effects
  • Humans
  • Iatrogenic Disease
  • Kidney / drug effects
  • Kidney / physiopathology
  • Kidney / surgery
  • Kidney Neoplasms / drug therapy*
  • Kidney Neoplasms / surgery
  • Mannitol / adverse effects
  • Mannitol / pharmacology*
  • Mannitol / toxicity
  • Nephrectomy / adverse effects*
  • Nephrectomy / methods
  • Postoperative Complications / prevention & control
  • Renal Insufficiency, Chronic / etiology
  • Reperfusion Injury / physiopathology
  • Reperfusion Injury / prevention & control

Substances

  • Diuretics, Osmotic
  • Mannitol