. . . and high doses appear to be associated with ototoxicity.
Furosemide is used frequently to convert oliguric to nonoliguric renal
failure in patients with early acute renal failure; the intention is
to reduce the need for dialysis. Australian investigators conducted a
meta-analysis to determine whether this intervention is successful.
They identified nine randomized controlled trials that included 849
patients with or at risk for acute renal failure; the
largest trial by far was reported in Journal Watch. The analysis
found no effect of furosemide on the following outcome measures:
mortality, risk for requiring renal replacement therapy or dialysis,
number of dialysis sessions needed, and proportion of patients with
persistent oliguria. Stratifying the studies on the basis of whether
furosemide was used for treatment or prevention did not change the
results. An increased incidence of tinnitus and temporary deafness
was noted in patients treated with high-dose furosemide.
Comment: Although furosemide may be used to induce diuresis in
patients with acute renal failure, it provides no overall benefit for
such patients and can cause side effects at high doses. At the time
of publication, the full
text of the original article was available free of charge.
— Keith I. Marton, MD
Published in Journal Watch September 26, 2006
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