Mannitol-induced acute renal failure.
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.
van Hengel
P
P
Department of Internal Medicine, Drechtsteden Ziekenhuis, AK Dordrecht, Netherlands.
Nikken
J J
JJ
de Jong
G M
GM
Hesp
W L
WL
van Bommel
E F
EF
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
D004234:Diuretics, Osmotic; D008353:Mannitol