Idiopathic
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In Acute Tubular Necrosis, what is the main reason for administration of a loop diuretic during the oliguric phase?
a. may convert the Px to a more manageable condition
b. improves outcome
c. fluid retention due to excess ADH secretion
d. reverses ischemic necrosis
e. this is not the Rx for ATN
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| asmi
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its E
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| Idiopathic
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Its A actually.
The goal of giving a loop is to convert an oliguric Px to a polyuric Px, because it is easier to manage a polyuric Px in acute renal failure. It does not improve the outcome, but the doc can rely on adequate fluid movement, he/she has more at his/her disposal.
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| asmi
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thanks 
we can use osmotic diuretics as well.
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| sunman
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Loops are the only diuretics that work in acute kidney failure.
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| asmi
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Examples include mannitol (Osmitrol®, Baxter Healthcare Corp.and others), glycerin (Osmoglyn®, Alcon Labs), isosorbide (Ismotic®, Alcon Labs)
Osmotic diuretics are generally used in a hospital setting. Osmotic substances have the ability to draw water out of tissues into the blood which can then be filtered by the kidneys and eliminated as urine. Mannitol, which is administered intravenously, is used to reduce excess fluid accumulation or pressure particularly in the head, and to increase urine flow in certain types of kidney failure or in the presence of drugs that have a potential to harm the kidneys. Mannitol is also used to increase urinary excretion of toxins or drugs in overdose cases. Some osmotic agents are given orally (isosorbide, glycerin) or as eye drops (glycerin) to reduce pressure in the eye associated with narrow-angle glaucoma or before eye surgery, as well as during eye examinations in the presence of corneal edema.
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| Idiopathic
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The idea though is not to remove fluid, but to maintain fluid flow through the kidney. Mannitol tends to have other major systemic effects, and a loop is specifically indicated in Rx of the oliguric phase of ARF.
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| asmi
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I agree with it idiopathic, I was just telling about osmotic diuretics....
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