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Updated: May 30, 2025
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A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
Published on: February 2, 2021
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Diuretics for preventing and treating acute kidney injury
Hiroyuki Hashimoto1, Hiroyuki Yamada2,3, Maki Murata4
1Department of Pharmacoepidemiology, Kyoto University, Kyoto, Japan.
The Cochrane Database of Systematic Reviews
|January 29, 2025
Summary
Diuretics may reduce the risk of acute kidney injury (AKI) and kidney replacement therapy (KRT) use. However, evidence for treating established AKI with diuretics is limited, necessitating further research.
Area of Science:
- Nephrology
- Critical Care Medicine
- Pharmacology
Background:
- Acute kidney injury (AKI) is a common complication in critical illnesses, increasing morbidity and mortality.
- Diuretics are frequently used to manage fluid overload and oliguria in AKI.
- The precise role of diuretics in AKI prevention and treatment requires comprehensive evaluation.
Purpose of the Study:
- To systematically review the benefits and harms of diuretics for AKI prevention.
- To systematically review the benefits and harms of diuretics for AKI treatment.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs) and quasi-RCTs.
- Searched the Cochrane Kidney and Transplant Register of Studies up to May 2024.
- Assessed risk of bias and certainty of evidence using the GRADE approach.
Main Results:
- For AKI prevention, diuretics may reduce AKI incidence (low-certainty evidence) and KRT use (moderate-certainty evidence).
- Diuretics probably reduce death in AKI prevention (moderate-certainty evidence).
- For AKI treatment, diuretics showed little to no difference in KRT use or death (low-certainty evidence), but may increase hypotension and arrhythmias.
Conclusions:
- Diuretics may offer benefits in AKI prevention, potentially reducing AKI incidence and KRT need.
- Evidence supporting the use of diuretics for established AKI treatment is limited.
- Further RCTs are needed to clarify the role of diuretics in treating established AKI.
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