Use of loop diuretics in the critically ill

Contrib Nephrol. 2010:165:219-225. doi: 10.1159/000313761. Epub 2010 Apr 20.

Abstract

Diuretics are commonly used in the intensive care unit, especially for patients with oliguric acute kidney injury. This practice is controversial since there is a lack of evidence regarding any beneficial effects of diuretics either on prevention or treatment of acute kidney injury. Some data even suggest harm when diuretics are used with the goal to influence renal function. However, diuretics can minimize fluid overload, making patient management easier and potentially avoiding many cardiopulmonary and non-cardiopulmonary complications. We will briefly review the available evidence for and against the use of diuretics in the critically ill, including cardiorenal syndromes.

MeSH terms

  • Acute Kidney Injury / therapy*
  • Critical Illness / therapy*
  • Heart Diseases / chemically induced
  • Heart Diseases / prevention & control
  • Humans
  • Intensive Care Units
  • Lung Diseases / prevention & control
  • Oliguria / drug therapy
  • Renal Replacement Therapy / adverse effects
  • Sodium Potassium Chloride Symporter Inhibitors / therapeutic use*

Substances

  • Sodium Potassium Chloride Symporter Inhibitors