Therapy

• Loading dose 120 - 240 mg frusemide , followed by an infusion of 20 mg/h
• If unable to give as infusion, give 120 mg over one hour every 6 h
• Reduce dose if creatinine falling
• Titrate dose to urine output

• High-dose loop diuretics increase urine flow in patients treated with dopamine and mannitol, but seizures are more common. ^a
• The time to dialysis is longer (~ 3 days), but the duration of dialysis is similar (~13 days) ^a . However there is no clear effect on mortality or renal recovery. ^d

High-dose loop diuretics increase urine flow, but cause more seizures

Patient	Treatment	Comparison	Outcome	CER	RRR (95% CI)	NNT (95% CI)
acute renal failure due to renal causes a	high-dose loop diuretics	placebo	increase in urine flow at 21 days	23%	120% (11% to 340%)	4 (2 to 12)
			seizure at 21 days	3.3%	-480% (-4200% to 21%)	-6 (-23 to -4)