What is the role of diuretics in the treatment of acute tubular necrosis (ATN)?

Updated: Mar 15, 2021
  • Author: Sangeeta Mutnuri, MBBS; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

In the past, the use of diuretics to convert an oliguric AKI to non-oliguric AKI was sometimes recommended, to help with fluid management. However, several meta-analyses have shown no reduction in mortality or the need for renal replacement therapy with the use of diuretics. [26]  

The only indication of diuretics would be fluid overload after appropriate management of sepsis and cardiac dysfunction. Intravenous furosemide or bumetanide in a single high dose (ie, 100-200 mg of furosemide) is commonly used, although little evidence indicates that it changes the course of ATN. The drug should be infused slowly because high doses can lead to hearing loss. If no response occurs, the treatment should be discontinued.

There is no role for so-called renal dose dopamine in the management of ATN. [27]


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