Mehta RL, Pascual MT, Soroko S, Chertow GM; PICARD Study Group.
Diuretics, mortality, and nonrecovery of renal function in acute renal failure.
JAMA 2002; 288: 2547-53. Gilmer T, Teetzel HD et al.
The use of diuretics in critically ill patients with acute renal failure was associated with an increased risk of death and nonrecovery of renal function. Although observational data prohibit causal inference, it is unlikely that diuretics afford any material benefit in this clinical setting. In the absence of compelling contradictory data from a randomized, blinded clinical trial, the widespread use of diuretics in critically ill patients with acute renal failure should be discouraged.
Point for discussion:
Surely diuretics have been taken off the ICU menu for ARF?