What is the role of albumin in the management of acute renal failure in intrarenal azotemia?

Updated: Sep 19, 2018
  • Author: Moro O Salifu, MD, MPH, FACP; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Albumin can be administered in combination with high-dose furosemide to enhance the diuretic effect of furosemide. The use of albumin in this context is not for volume expansion; rather, it allows more furosemide to be bound to albumin for delivery to the organic anion transporter in the kidney, thereby enabling more furosemide to enter the tubule than would otherwise do so.

Although this approach is widely used, research on the combination of albumin and a loop diuretic has principally studied its use for improving diuretic-resistant edema in patients with nephrotic syndrome. [15] Other therapies that have not been conclusively shown to be beneficial are renal-dose dopamine and synthetic atrial natriuretic peptide.


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