Diuretics in Acute Kidney Injury
Summary Acute kidney injury (AKI) is common in hospitalized patients and is associated with significant morbidity and mortality. The incidence of AKI is increasing and despite clinical advances there has been little change in the outcomes associated with AKI. A variety of interventions, including lo...
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| Veröffentlicht in: | Seminars in nephrology 2011-11, Vol.31 (6), p.523-534 |
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| creator | Nigwekar, Sagar U., MD Waikar, Sushrut S., MD, MPH |
| description | Summary Acute kidney injury (AKI) is common in hospitalized patients and is associated with significant morbidity and mortality. The incidence of AKI is increasing and despite clinical advances there has been little change in the outcomes associated with AKI. A variety of interventions, including loop diuretics, have been tested for the prevention and treatment of AKI; however, none to date have shown convincing benefits in clinical studies, and the management of AKI remains largely supportive. In this article, we review the pharmacology and experimental and clinical evidence for loop diuretics in the management of AKI. In addition, we also review evidence for other agents with diuretic and/or natriuretic properties such as thiazide diuretics, mannitol, fenoldopam, and natriuretic peptides in both the prevention and treatment of AKI. Implications for current clinical practice are outlined to guide clinical decisions in this field. |
| doi_str_mv | 10.1016/j.semnephrol.2011.09.007 |
| format | Article |
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The incidence of AKI is increasing and despite clinical advances there has been little change in the outcomes associated with AKI. A variety of interventions, including loop diuretics, have been tested for the prevention and treatment of AKI; however, none to date have shown convincing benefits in clinical studies, and the management of AKI remains largely supportive. In this article, we review the pharmacology and experimental and clinical evidence for loop diuretics in the management of AKI. In addition, we also review evidence for other agents with diuretic and/or natriuretic properties such as thiazide diuretics, mannitol, fenoldopam, and natriuretic peptides in both the prevention and treatment of AKI. Implications for current clinical practice are outlined to guide clinical decisions in this field.</description><identifier>ISSN: 0270-9295</identifier><identifier>EISSN: 1558-4488</identifier><identifier>DOI: 10.1016/j.semnephrol.2011.09.007</identifier><identifier>PMID: 22099509</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Acute kidney injury ; Acute Kidney Injury - drug therapy ; diuretics ; Diuretics - pharmacokinetics ; Diuretics - pharmacology ; Diuretics - therapeutic use ; Diuretics, Osmotic - pharmacology ; Diuretics, Osmotic - therapeutic use ; fenoldopam ; Fenoldopam - pharmacology ; Fenoldopam - therapeutic use ; Humans ; natriuretic peptides ; Natriuretic Peptides - pharmacology ; Natriuretic Peptides - therapeutic use ; Nephrology ; Sodium Chloride Symporter Inhibitors - pharmacology ; Sodium Chloride Symporter Inhibitors - therapeutic use ; Sodium Potassium Chloride Symporter Inhibitors - pharmacokinetics ; Sodium Potassium Chloride Symporter Inhibitors - pharmacology ; Sodium Potassium Chloride Symporter Inhibitors - therapeutic use</subject><ispartof>Seminars in nephrology, 2011-11, Vol.31 (6), p.523-534</ispartof><rights>Elsevier Inc.</rights><rights>2011 Elsevier Inc.</rights><rights>Copyright © 2011 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c428t-3fb1171e3453fdd06b4a516a7110dcd3d2446b0e2debc6ac870ae12eac58685e3</citedby><cites>FETCH-LOGICAL-c428t-3fb1171e3453fdd06b4a516a7110dcd3d2446b0e2debc6ac870ae12eac58685e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.semnephrol.2011.09.007$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22099509$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nigwekar, Sagar U., MD</creatorcontrib><creatorcontrib>Waikar, Sushrut S., MD, MPH</creatorcontrib><title>Diuretics in Acute Kidney Injury</title><title>Seminars in nephrology</title><addtitle>Semin Nephrol</addtitle><description>Summary Acute kidney injury (AKI) is common in hospitalized patients and is associated with significant morbidity and mortality. The incidence of AKI is increasing and despite clinical advances there has been little change in the outcomes associated with AKI. A variety of interventions, including loop diuretics, have been tested for the prevention and treatment of AKI; however, none to date have shown convincing benefits in clinical studies, and the management of AKI remains largely supportive. In this article, we review the pharmacology and experimental and clinical evidence for loop diuretics in the management of AKI. In addition, we also review evidence for other agents with diuretic and/or natriuretic properties such as thiazide diuretics, mannitol, fenoldopam, and natriuretic peptides in both the prevention and treatment of AKI. Implications for current clinical practice are outlined to guide clinical decisions in this field.</description><subject>Acute kidney injury</subject><subject>Acute Kidney Injury - drug therapy</subject><subject>diuretics</subject><subject>Diuretics - pharmacokinetics</subject><subject>Diuretics - pharmacology</subject><subject>Diuretics - therapeutic use</subject><subject>Diuretics, Osmotic - pharmacology</subject><subject>Diuretics, Osmotic - therapeutic use</subject><subject>fenoldopam</subject><subject>Fenoldopam - pharmacology</subject><subject>Fenoldopam - therapeutic use</subject><subject>Humans</subject><subject>natriuretic peptides</subject><subject>Natriuretic Peptides - pharmacology</subject><subject>Natriuretic Peptides - therapeutic use</subject><subject>Nephrology</subject><subject>Sodium Chloride Symporter Inhibitors - pharmacology</subject><subject>Sodium Chloride Symporter Inhibitors - therapeutic use</subject><subject>Sodium Potassium Chloride Symporter Inhibitors - pharmacokinetics</subject><subject>Sodium Potassium Chloride Symporter Inhibitors - pharmacology</subject><subject>Sodium Potassium Chloride Symporter Inhibitors - therapeutic use</subject><issn>0270-9295</issn><issn>1558-4488</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkbtO7DAQhi0EguXyCkfpqBJmnNiJGyTuIJAogNpy7FnhkE0WO0HatyerhYNERTXNf9F8P2MJQoaA8qTJIi06Wr6Gvs04IGagMoByi81QiCotiqraZjPgJaSKK7HH9mNsADiWHHfZHueglAA1Y8mlHwMN3sbEd8mZHQdK7r3raJXcdc0YVodsZ27aSEdf94C9XF89X9ymD483dxdnD6kteDWk-bxGLJHyQuRz50DWhREoTYkIzrrc8aKQNRB3VFtpbFWCIeRkrKhkJSg_YMeb3GXo30eKg174aKltTUf9GLUCIUuhZDEpq43Shj7GQHO9DH5hwkoj6DUe3egfPHqNR4PSE57J-u-rZKwX5P4bv3lMgvONgKZXPzwFHa2nzpLzgeygXe__0nL6K8S2vvPWtG-0otj0Y-gmlBp15Br003qm9UoTKsBclvknsYGPJw</recordid><startdate>20111101</startdate><enddate>20111101</enddate><creator>Nigwekar, Sagar U., MD</creator><creator>Waikar, Sushrut S., MD, MPH</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20111101</creationdate><title>Diuretics in Acute Kidney Injury</title><author>Nigwekar, Sagar U., MD ; Waikar, Sushrut S., MD, MPH</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c428t-3fb1171e3453fdd06b4a516a7110dcd3d2446b0e2debc6ac870ae12eac58685e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Acute kidney injury</topic><topic>Acute Kidney Injury - drug therapy</topic><topic>diuretics</topic><topic>Diuretics - pharmacokinetics</topic><topic>Diuretics - pharmacology</topic><topic>Diuretics - therapeutic use</topic><topic>Diuretics, Osmotic - pharmacology</topic><topic>Diuretics, Osmotic - therapeutic use</topic><topic>fenoldopam</topic><topic>Fenoldopam - pharmacology</topic><topic>Fenoldopam - therapeutic use</topic><topic>Humans</topic><topic>natriuretic peptides</topic><topic>Natriuretic Peptides - pharmacology</topic><topic>Natriuretic Peptides - therapeutic use</topic><topic>Nephrology</topic><topic>Sodium Chloride Symporter Inhibitors - pharmacology</topic><topic>Sodium Chloride Symporter Inhibitors - therapeutic use</topic><topic>Sodium Potassium Chloride Symporter Inhibitors - pharmacokinetics</topic><topic>Sodium Potassium Chloride Symporter Inhibitors - pharmacology</topic><topic>Sodium Potassium Chloride Symporter Inhibitors - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nigwekar, Sagar U., MD</creatorcontrib><creatorcontrib>Waikar, Sushrut S., MD, MPH</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Seminars in nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nigwekar, Sagar U., MD</au><au>Waikar, Sushrut S., MD, MPH</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diuretics in Acute Kidney Injury</atitle><jtitle>Seminars in nephrology</jtitle><addtitle>Semin Nephrol</addtitle><date>2011-11-01</date><risdate>2011</risdate><volume>31</volume><issue>6</issue><spage>523</spage><epage>534</epage><pages>523-534</pages><issn>0270-9295</issn><eissn>1558-4488</eissn><abstract>Summary Acute kidney injury (AKI) is common in hospitalized patients and is associated with significant morbidity and mortality. The incidence of AKI is increasing and despite clinical advances there has been little change in the outcomes associated with AKI. A variety of interventions, including loop diuretics, have been tested for the prevention and treatment of AKI; however, none to date have shown convincing benefits in clinical studies, and the management of AKI remains largely supportive. In this article, we review the pharmacology and experimental and clinical evidence for loop diuretics in the management of AKI. In addition, we also review evidence for other agents with diuretic and/or natriuretic properties such as thiazide diuretics, mannitol, fenoldopam, and natriuretic peptides in both the prevention and treatment of AKI. Implications for current clinical practice are outlined to guide clinical decisions in this field.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>22099509</pmid><doi>10.1016/j.semnephrol.2011.09.007</doi><tpages>12</tpages></addata></record> |
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| ispartof | Seminars in nephrology, 2011-11, Vol.31 (6), p.523-534 |
| issn | 0270-9295 1558-4488 |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Acute kidney injury Acute Kidney Injury - drug therapy diuretics Diuretics - pharmacokinetics Diuretics - pharmacology Diuretics - therapeutic use Diuretics, Osmotic - pharmacology Diuretics, Osmotic - therapeutic use fenoldopam Fenoldopam - pharmacology Fenoldopam - therapeutic use Humans natriuretic peptides Natriuretic Peptides - pharmacology Natriuretic Peptides - therapeutic use Nephrology Sodium Chloride Symporter Inhibitors - pharmacology Sodium Chloride Symporter Inhibitors - therapeutic use Sodium Potassium Chloride Symporter Inhibitors - pharmacokinetics Sodium Potassium Chloride Symporter Inhibitors - pharmacology Sodium Potassium Chloride Symporter Inhibitors - therapeutic use |
| title | Diuretics in Acute Kidney Injury |
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