Which medications in the drug class Diuretics, Loop are used in the treatment of Acute Kidney Injury?

Updated: Dec 24, 2020
  • Author: Biruh T Workeneh, MD, PhD, FASN; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Diuretics, Loop

Although diuretics seem to have no effect on the outcome of established AKI, they appear to be useful in fluid homeostasis and are used extensively. They have also been used to reduce the requirement for renal replacement therapy. The use of isotonic sodium chloride solution in conjunction with diuretics is debatable.

Furosemide (Lasix)

Furosemide increases the excretion of water by interfering with the chloride-binding cotransport system, which, in turn, inhibits sodium and chloride reabsorption in the thick ascending loop of Henle and the distal renal tubule. It is a potent and rapid-acting agent with peak action at 60 minutes and a 6- to 8-hour duration of action.

In renal failure, higher doses must be used for greater diuretic effect. Doses as high as 600 mg/day may be needed under monitored conditions.

Frequently, IV doses are needed in AKI to maintain urine output. IV infusions are often helpful in intensive care settings, in which larger doses are necessary. This method promotes a sustained natriuresis with reduced ototoxicity compared with conventional intermittent bolus dosing.

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