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November 27, 2002

Loop Diuretics for Patients With Acute Renal FailureHelpful or Harmful?

Author Affiliations

Author Affiliations: Renal Division, University Hospital, Ghent, Belgium.

JAMA. 2002;288(20):2599-2601. doi:10.1001/jama.288.20.2599

Intrinsic acute renal failure (ARF) that does not result from primary vascular, glomerular, or interstitial disorders has been ascribed to acute tubular necrosis and accounts for approximately 45% of cases of hospital-acquired ARF.1 While acute tubular necrosis usually is caused by ischemic (50%) or nephrotoxic (35%) injury to the kidney,2 the cause is often multifactorial. Unfortunately, neither the occurrence of acute tubular necrosis nor the morbidity and mortality associated with it have declined despite ongoing improvement in the supportive care of patients with renal failure and the advent and availability of intermittent and continuous dialysis.3,4 One reason for this lack of improvement is a change in the severity of the underlying diseases causing ARF.1,4,5

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