title: Mannitol-induced acute renal failure.
abstract: Mannitol is widely used because of its osmotic diuretic action and its presumed antioxidant properties. In pre-existent renal dysfunction, however, mannitol may accumulate leading to potentially deleterious effects. We describe a 71-year-old woman with moderate chronic renal failure due to diabetic nephropathy who developed acute anuric renal failure after mannitol administration for post-traumatic reflex sympathetic dystrophy. After haemodialysis symptoms of acute renal failure rapidly disappeared with recovery of pre-existent renal function. Daily measurement of the osmolal gap as a simple and accurate way of monitoring patients receiving mannitol infusion is emphasized. A rapid increase in the osmolar gap should prompt adjustment of the dose or even discontinuation of mannitol, especially in the case of pre-existent risk factors.
authors.affiliation: Department of Internal Medicine, Drechtsteden Ziekenhuis, AK Dordrecht, Netherlands.
authors.forename: P
authors.initials: P
authors.lastname: van Hengel
authors.forename: J J
authors.initials: JJ
authors.lastname: Nikken
authors.forename: G M
authors.initials: GM
authors.lastname: de Jong
authors.forename: W L
authors.initials: WL
authors.lastname: Hesp
authors.forename: E F
authors.initials: EF
authors.lastname: van Bommel
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000628:therapy; D000368:Aged; D004234:Diuretics, Osmotic / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008353:Mannitol / Q000008:administration & dosage / Q000009:adverse effects*; D012019:Reflex Sympathetic Dystrophy / Q000150:complications / Q000188:drug therapy; D006435:Renal Dialysis
chemical_list: D004234:Diuretics, Osmotic; D008353:Mannitol