Mannitol-Induced Osmotic Diuresis During Renal Artery Occlusion

Ac, Beall; Cw, Hall; Gc, Morris; Me, Debakey

doi:10.1097/00000658-196501000-00007

Cited by 20 publications

(5 citation statements)

References 7 publications

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“…17 One animal study, 18 three case reports, 19-21 one review article, 22 and two technical notes were excluded. 23,24 One study was excluded because it reported on a small case series.…”

Section: Resultsmentioning

confidence: 99%

Juxtarenal aortic aneurysm repair

Jongkind

Yeung

Akkersdijk

et al. 2010

Journal of Vascular Surgery

177

144

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“…17 One animal study, 18 three case reports, 19-21 one review article, 22 and two technical notes were excluded. 23,24 One study was excluded because it reported on a small case series.…”

Section: Resultsmentioning

confidence: 99%

Juxtarenal aortic aneurysm repair

Jongkind

Yeung

Akkersdijk

et al. 2010

Journal of Vascular Surgery

177

144

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“…There is general agreement that adequate hydration prior to various threats to renal integrity has a protective effect, but treatment with mannitol has not been consistently more effective than other means of hydration (1,3,4,9,23,25) despite the more marked diuresis which occurs with this agent.…”

Section: Discussionmentioning

confidence: 99%

Glycerol Induced Hemoglobinuric Acute Renal Failure in the Rat

Dr¹,

Thiel²,

Ml³

et al. 1967

Nephron

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The effectiveness of plasma infusion, saline injection, mannitol infusion and combined treatment with mannitol and saline in modifying the development of glycerol-induced hemoglobinuric acute renal failure was studied in the rat. All modes of therapy decreased the severity of azotemia considerably, and combined treatment with mannitol and saline almost totally prevented the development of azotemia. The intrarenal effects of prophylactic treatment on individual nephron function were studied by micropuncture techniques. Function of the best nephrons was comparable in all therapeutic groups, the degree of renal insufficiency in each group being a manifestation of the proportion of those nephrons which had only moderately diminished function. The effectiveness of each agent correlated with the prevention of severe renal ischemia shortly after glycerol injection. Their ability to modify GFR in dehydrated control rats did not correlate well with the degree of protection afforded after glycerol injection. Improvement in extracellular fluid volume was not the prime feature associated with protection from azotemia.

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“…(2) A salubrious effect of diuresis in defense of renal function is equally implied in recommendations for specific osmotic diuretic agents (12,20) and for adequate resuscitation and hydration alone (10,15) in several traumatic situations.…”

Section: Discussionmentioning

confidence: 99%

“…In particular, hydration and osmotic diuresis (e.g., as induced by infu sion of hypertonic mannitol) have been recommended to reduce or virtually to eliminate the risk of acute renal failure in such situations as crush injury (14), hemolytic transfusion reaction (8,24), elective surgery including aortic resection (4,6,12,36), extracorporeal circula tion (23), and accidental trauma (9,16). Other agents have also been recommended (3,35), and both the necessity and the safety of osmotic diuresis has been questioned (10,21,22,39,40,47). Failures to prevent renal insufficiency by means of osmotic diuresis have been reported 7 ,1 1 ,2 5 ).…”

Section: Introductionmentioning

confidence: 99%

Studies in Acute Renal Failure

Teschan

Lawson²

1966

Nephron

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In a previously documented experimental model of acute renal failure in the rat (intravenous methemoglobin-ferrocyanide) 1 ml doses of 25% mannitol (1.21–1.54 g/kg) intravenously prevented both functional and histologic renal injury within –1 h and +30 min of attempted induction. When varying mannitol doses were given 15 min following attempted induction, a sigmoid log-log relationship of plasma urea nitrogen (PUN) concentration to mannitol dose was demonstrated. Mannitol doses above 300 mg/kg (at + 15 min) are estimated to be fully protective in the model. Similarly at 15 min following attempted induction, isosmolal 1 ml doses of aqueous mannitol, mannose, sucrose, sodium sulfate, sodium chloride, THAM [tris(hydroxymethyl)aminomethane] and thriceisosmolal urea prevented acute renal failure, but isosmolal urea and dextrose, isotonic saline and 6% human serum albumin did not. Both 6% dextran (av. mol. wt. 75,000) and 10% dextran (av. mol. wt. 40,000) intensified the lesions, possibly a unique reaction in the rat. Effective agents induced higher rates of urinary flow in anesthetized, normal rats than ineffective ones. The results indicate that, in this model, (a) several osmotic diuretic agents are capable of preventing acute renal failure; (b) preventive effectiveness correlates with the ability of an agent to induce prompt, brisk diuresis; (c) the preventive therapy must be timely to be effective; and (d) the probable protective mechanism is that the agent augments the pathogenetically-significant, reduced renal tubular fluid flow. The results also imply that the protective mechanism does not depend upon extracellular or plasma volume expansion, relief of renal ischemia, osmotic loading per se, or a specific chemical or pharmacological characteristic of any single agent.

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Mannitol-Induced Osmotic Diuresis During Renal Artery Occlusion

Cited by 20 publications

References 7 publications

Juxtarenal aortic aneurysm repair

Juxtarenal aortic aneurysm repair

Glycerol Induced Hemoglobinuric Acute Renal Failure in the Rat

Studies in Acute Renal Failure

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