Trauma, acute kidney injury and mannitol

Traumatic injury is a risk factor for acute kidney injury (AKI). The cause of AKI is likely multifactorial and may include renal hypoperfusion and renal hypoxia secondary to hypovolemic shock and/or increased abdominal pressure, rhabdomyolysis and direct nephrotoxic effects of therapy including general anesthesia (Harris et al., 2017). The osmotic diuretic, mannitol, has been used both in the prevention, and the treatment of AKI. It has been used peri-operatively to prevent the development of AKI and in the management of AKI secondary to traumatic rhabdomyolysis (Sharman et al., 2013; Yang et al., 2014). However, mannitol itself has nephrotoxic potential and therefore the benefits of its use should be considered in light of its potential to cause adverse effects (Perez-Perez et al., 2002;  Fang et al., 2010)

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Furosemide use in management of acute kidney injury: magic bullet or fatal blow?

Furosemide is the most commonly used diuretic in critical care and is frequently used in the management of acute kidney injury (AKI). However, the benefits of furosemide administration in AKI has long been questioned and there are concerns over the possible harmful effects of furosemide including diuretic-induced AKI. To further evaluate the role of furosemide in management of AKI, let us consider a case. 

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