Study says diuretics may harm kidney patients

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http://www.charlotte.com/mld/observer/news/4622952.htm

Study says diuretics may harm kidney patients

Scientists find higher death rate when used

ROSIE MESTEL

Los Angeles Times

 

 

 

The common practice of using diuretics to treat acute kidney failure may do more

harm than good, according to a new California study.

 

Patients whose kidneys go into sudden failure are often given diuretics -- drugs

to help rid the body of accumulating fluid. But the study, reported in

Wednesday's Journal of the American Medical Association, found that patients

given these drugs had a 68 percent higher death rate than those who were not.

 

The authors and several kidney experts stressed that the study cannot conclude

for sure that the diuretics caused the increased death rate. For example, on

average, the patients given diuretics were older and sicker to begin with, and

while the authors tried to control for such factors, they may not have been able

to do so perfectly.

 

But the findings add to a body of research suggesting that diuretics often may

do little good for such patients. It suggests that doctors must monitor people

with acute kidney failure closely and make sure that they don't delay other

treatments, such as dialysis, if the patients are not responding to diuretics.

 

The study examined only patients with acute kidney failure, and has no bearing

on patients with chronic kidney failure.

 

The study was conducted by a team of researchers led by Dr. Ravindra Mehta,

professor of medicine and director of the clinical nephrology and dialysis

programs at the University of California, San Diego. Examining the records of

552 patients, the scientists found not only a higher death rate in patients

given diuretics but also a higher rate of subsequent chronic kidney failure

requiring dialysis. The death rate was especially high in patients who failed to

quickly respond to the diuretics with an increased flow of urine.

 

" I think this should call for a reappraisal of our frequent use of diuretics in

critically ill patients with acute kidney failure, " Mehta said.

 

Dr. Richard Lafayette, associate professor of medicine and clinical chief in the

division of nephrology at Stanford University, said the evidence is still not

strong enough to warrant a change in medical practice.

 

 

 

 

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