Meta-analysis does not support furosemide for treating or preventing acute renal failure
Patients do not benefit from the use of furosemide for the treatment or prevention of acute renal failure, a recent study published in the
BMJ has shown (2006;333:420).
A meta-analysis of nine randomised controlled trials, with a total of
849 patients with or at risk of acute renal failure, showed no improvement
after furosemide treatment for in-hospital mortality (relative risk 1.11,
95 per cent confidence interval 0.92–1.33; P=0.28), for risk of
renal replacement therapy or dialysis (0.99, CI 0.80–1.22; P=0.91),
or for the proportion of patients with urine output persistently less
than 500ml/day (0.54, CI 0.18–1.61; P=0.27). Furthermore, evidence
of temporary deafness and tinnitus (due to ototoxicity) was shown for
patients receiving high doses of the drug (1–3.4g/day; relative
risk 3.97, CI 1.00–15.78; P=0.05).
The authors say their results agree with the theory that “a positive
diuretic response to furosemide may indicate that patients have a milder
form of acute renal failure rather than furosemide being capable of converting
a more severe form of acute renal failure to a less severe form and improve
the outcome”. |
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