This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in JAMA  Topic Collections  • Acute Renal Failure  • Alert me on articles by topic  Social Bookmarking   What's this?

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: Dr Mehta and colleagues¹ suggested that the adverse outcome of diuretic use in patients with ARF is related either to a direct effect of diuretics or a delay in initiating dialysis. We are concerned that the results do not justify either of these conclusions.

As shown in Figure 2, higher mortality rates occurred in the patients given diuretics, but who were diuretic resistant (furosemide equivalent per milliliter ratio 1.0). Mortality rates were similar, however, for the no diuretic and diuretic-responsive groups. Thus, oliguric ARF had a poorer outcome than nonoliguric ARF. Failure to respond to diuretics reflects severe renal disease; the poor outcome in this group reflects the poorer prognosis of oliguric ARF.² No direct causal effect between diuretic use and poor outcome can be inferred from these results.

Mehta et al suggested that diuretic use prolonged the interval from consultation to dialysis. However, they offer no . . . [Full Text of this Article]

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLES

Diuretics in Critically Ill Patients With Acute Renal Failure
Michael Emmett
JAMA. 2003;289(11):1379.
EXTRACT | FULL TEXT  

Diuretics in Critically Ill Patients With Acute Renal Failure
James V. Tedesco
JAMA. 2003;289(11):1379.
EXTRACT | FULL TEXT  

Diuretics in Critically Ill Patients With Acute Renal Failure
Tihomir Stefanec
JAMA. 2003;289(11):1380.
EXTRACT | FULL TEXT  

Diuretics in Critically Ill Patients With Acute Renal Failure
Kamyar Kalantar-Zadeh
JAMA. 2003;289(11):1380.
EXTRACT | FULL TEXT  

Diuretics in Critically Ill Patients With Acute Renal Failure—Reply
Ravindra L. Mehta and Glenn M. Chertow
JAMA. 2003;289(11):1380-1381.
EXTRACT | FULL TEXT  

Diuretics, Mortality, and Nonrecovery of Renal Function in Acute Renal Failure
Ravindra L. Mehta, Maria T. Pascual, Sharon Soroko, Glenn M. Chertow, and for the PICARD Study Group
JAMA. 2002;288(20):2547-2553.
ABSTRACT | FULL TEXT