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Loop Diuretics and Mortality in Patients with Acute Kidney Injury

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Reducing Mortality in Acute Kidney Injury

Abstract

Critically ill patients are at high risk of fluid retention. Loop diuretics are frequently used for prevention or treatment of volume overload in patients with or at risk for acute kidney injury (AKI). Other indications include hyperkalemia, hypercalcemia, and hyperazotemia. Several trials investigated the impact of loop diuretics on survival in patients with AKI. Their results are mostly inconclusive. The most recent KDIGO guidelines do not recommend the use of loop diuretics for prevention or treatment of AKI.

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References

  1. Bagshaw SM, Bellomo R, Kellum JA (2008) Oliguria, volume overload, and loop diuretics. Crit Care Med 36(4 Suppl):S172–S178

    Article  PubMed  Google Scholar 

  2. Karajala V, Mansour W, Kellum JA (2009) Diuretics in acute kidney injury. Minerva Anestesiol 75(5):251–257

    CAS  PubMed  Google Scholar 

  3. RimmelĂ© T, Karajala V, Murugan R, Kellum JA (2010) Use of loop diuretics in the critically ill. Contrib Nephrol 165:219–225

    Article  PubMed  Google Scholar 

  4. Payen D, de Pont AC, Sakr Y et al (2008) A positive fluid balance is associated with worse outcome in patients with acute renal failure. Crit Care 12(3):R74

    Article  PubMed  PubMed Central  Google Scholar 

  5. Bouchard J, Soroko SB, Chertow GM et al (2009) Fluid accumulation, survival, and recovery of kidney function in critically ill patients with acute kidney injury. Kidney Int 76:422–427

    Article  PubMed  Google Scholar 

  6. Landoni G, Bove T, SzĂ©kely A et al (2013) Reducing mortality in acute kidney injury patients: systematic review and international web-based survey. J Cardiothorac Vasc Anesth 27(6):1384–1398

    Article  PubMed  Google Scholar 

  7. Brienza N, Giglio MT, Marucci M, Fiore T (2009) Does perioperative hemodynamic optimization protect renal function in surgical patients? A meta-analytic study. Crit Care Med 37(6):2079–2090

    Article  PubMed  Google Scholar 

  8. Mehta RL, Pascual MT, Soroko S, Chertow GM, PICARD Study Group (2002) Diuretics, mortality, and nonrecovery of renal function in acute renal failure. JAMA 288(20):2547–2553

    Article  CAS  PubMed  Google Scholar 

  9. Bagshaw SM, Delaney A, Haase M et al (2007) Loop diuretics in the management of acute renal failure: a systematic review and meta-analysis. Crit Care Resusc 9:60–68

    PubMed  Google Scholar 

  10. Ho KM, Sheridan DJ (2006) Meta-analysis of frusemide to prevent or treat acute renal failure. BMJ 333:420

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Ho KM, Power BM (2010) Benefits and risks of furosemide in acute kidney injury. Anaesthesia 65(3):283–293

    Article  CAS  PubMed  Google Scholar 

  12. Sampath S, Moran JL, Graham PL et al (2007) The efficacy of loop diuretics in acute renal failure: assessment using Bayesian evidence synthesis techniques. Crit Care Med 35(11):2516–2524

    Article  CAS  PubMed  Google Scholar 

  13. Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group (2012) KDIGO clinical practice guideline for acute kidney injury. Kidney Inter Suppl 2:1–138

    Article  Google Scholar 

  14. Levi TM, Rocha MS, Almeida DN et al (2012) Furosemide is associated with acute kidney injury in critically ill patients. Braz J Med Biol Res 45(9):827–833

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Wu X, Zhang W, Ren H et al (2014) Diuretics associated acute kidney injury: clinical and pathological analysis. Ren Fail 36(7):1051–1055

    Google Scholar 

  16. Dreischulte T, Morales DR, Bell S, Guthrie B (2015) Combined use of nonsteroidal anti-inflammatory drugs with diuretics and/or renin-angiotensin system inhibitors in the community increases the risk of acute kidney injury. Kidney Int 88(2):396–403

    Google Scholar 

  17. Oh SW, Han SY (2015) Loop diuretics in clinical practice. Electrolyte Blood Press 13(1):17–21

    Article  PubMed  PubMed Central  Google Scholar 

  18. Roush GC, Kaur R, Ernst ME (2014) Diuretics: a review and update. J Cardiovasc Pharmacol Ther 19(1):5–13

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Ɓukasz J. Krzych MD, PhD .

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Krzych, Ɓ.J., Czempik, P. (2016). Loop Diuretics and Mortality in Patients with Acute Kidney Injury. In: Landoni, G., Pisano, A., Zangrillo, A., Bellomo, R. (eds) Reducing Mortality in Acute Kidney Injury. Springer, Cham. https://doi.org/10.1007/978-3-319-33429-5_21

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  • DOI: https://doi.org/10.1007/978-3-319-33429-5_21

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-33427-1

  • Online ISBN: 978-3-319-33429-5

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