Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.
To the Editor: Dr Mehta and colleagues1 concluded that the use of diuretics in critically
ill patients with ARF is associated with a poor outcome. Even though the authors
indicate that observational data prohibit causal inference, they argue that
in the absence of compelling contradictory data from clinical trials, the
widespread use of diuretics in critically ill patients with ARF should be
discouraged. This conclusion, however, may be flawed since the methods used
by the authors do not regard the epidemiological theory of causality.
Kalantar-Zadeh K. Diuretics in Critically Ill Patients With Acute Renal FailureDiuretics in Critically Ill Patients With Acute Renal Failure. JAMA. 2003;289(11):1379-1381. doi:10.1001/jama.289.11.1379-a