Cookie policy: This site uses cookies (small files stored on your computer) to simplify and improve your experience of this website. Cookies are small text files stored on the device you are using to access this website. For more information please take a look at our terms and conditions. Some parts of the site may not work properly if you choose not to accept cookies.


Subscribe or Register

Existing user? Login

PJ Online | News: Diuretics associated with an increased risk of death in acute renal failure

Home > PJ (current issue) > News / Daily News | Search

Return to PJ Online Home Page

The Pharmaceutical Journal
Vol 269 No 7226 p771
30 November 2002

This article

News summary

Related websites
JAMA article (more)

Diuretics associated with an increased risk of death in acute renal failure

The use of diuretics in critically ill patients with acute renal failure is associated with an increased risk of death, a new study shows. Diuretics were also found to be associated with non-recovery of renal function in these patients.

Researchers analysed data collected over a six-year period for 552 patients with acute renal failure. They found that 59 per cent of patients were taking diuretics at the time of assessment and 12 per cent started taking diuretics after assessment.

A total of 294 (53 per cent) of the patients died in hospital, 56 of whom recovered renal function before death. Among those who survived, 17 were dialysis dependent after discharge. The increased risk of death or non-recovery of renal function was magnified (odds ratio 3.12, 95 per cent confidence interval, 1.14?2.76) when patients who died within the first week following assessment were excluded.

The researchers say that possible explanations for the association between diuretic use and both mortality in hospital and non-recovery of renal function include a direct toxic effect of diuretics or indirect effects either related or unrelated to renal function.

They say that although they cannot determine that diuretics are harmful, it is highly unlikely that diuretics afford patients with acute renal failure any material benefit. They conclude: "In the absence of compelling contradictory data from a randomised, blinded clinical trial, the widespread use of diuretics in critically ill patients with acute renal failure should be discouraged." (JAMA 2002;288:2547.)

Caroline Ashley, principal pharmacist, renal services, Royal Free Hospital, London, told The Journal that although it is difficult to say that the use of diuretics causes an increased risk of death and non-recoverable renal function, the study clearly raises concern about the prolonged use of diuretics in critically ill patients.

"We do know that in low doses, diuretics reduce tubular workload. It could be that in critically ill patients with poor renal function, large doses of diuretics are indeed harmful to kidneys. Alternatively, the diuretic therapy may have been continued for too long before dialysis was instigated," she said.

Back to Top

Home | Journals | News | Notice-board | Search | Jobs  Classifieds | Site Map | Contact us

©The Pharmaceutical Journal

Citation: The Pharmaceutical Journal URI: 20008285

Rate this article 

Click to rate

  • 1 star out of 5
  • 2 stars out of 5
  • 3 stars out of 5
  • 4 stars out of 5
  • 5 stars out of 5

0 out of 5 stars

Have your say

For commenting, please login or register as a user and agree to our Community Guidelines. You will be re-directed back to this page where you will have the ability to comment.

Recommended from Pharmaceutical Press

  • Introduction to Renal Therapeutics

    Introduction to Renal Therapeutics

    Introduction to Renal Therapeutics covers all aspects of drug use in renal failure. Shows the role of the pharmacist in patient care for chronic kidney disease.

    £38.00Buy now
  • Chronotherapeutics


    Chronotherapeutics discusses the pharmaceutical and therapeutic implications associated with biological clocks in humans.

    £38.00Buy now

Search an extensive range of the world’s most trusted resources

Powered by MedicinesComplete
  • Print
  • Share
  • Comment
  • Rate
  • Save
  • Print Friendly Version of this pagePrint Get a PDF version of this webpagePDF

Newsletter Sign-up

Want to keep up with the latest news, comment and CPD articles in pharmacy and science? Subscribe to our free alerts.