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Renal blood flow changes following mannitol infusion.

W R Castaneda-Zuniga, V Janata, I Beranek

    Revista Interamericana De Radiologia
    |January 1, 1978
    PubMed
    Summary
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    Mannitol infusion significantly increases renal blood flow in animals but minimally in humans. Its diuretic effect likely stems from osmotic pressure in tubules, not increased renal blood flow.

    Area of Science:

    • Nephrology
    • Pharmacology
    • Physiology

    Background:

    • Mannitol is a diuretic used clinically.
    • Its mechanism of action on renal physiology requires further elucidation.
    • Previous studies suggest osmotic effects contribute to its diuretic properties.

    Purpose of the Study:

    • To investigate the impact of mannitol infusion on renal physiology.
    • To compare the effects of mannitol on renal blood flow in experimental animals and humans.
    • To determine the primary mechanism behind mannitol's diuretic effect.

    Main Methods:

    • Renal physiology was assessed in experimental animals and human patients.
    • Para-aminohippuric acid (PAH) extraction and inulin clearance were used in animals.
    • Xenon133 washout technique measured renal blood flow in human patients.

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  • Baseline measurements were compared with post-intravenous mannitol infusion data.

    • Main Results:

    • Mannitol infusion led to a significant increase in total renal blood flow in experimental animals.
    • A minimal increase in total renal blood flow was observed in human patients after mannitol infusion.
    • The diuretic effect of mannitol appears independent of substantial increases in renal blood flow.

    Conclusions:

    • Mannitol's diuretic action is primarily attributed to its osmotic effect within renal tubules.
    • Increased interstitial renal pressure, rather than enhanced renal blood flow, likely drives mannitol's diuresis.
    • Clinical efficacy of mannitol in hypotensive patients with low renal blood flow supports this mechanism.