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Effects of Hypertonic Mannitol in Patients With Chronic Renal Insufficiency

Heino R. Anto, MD; Shyan-Yih Chou, MD; Jerome G. Porush, MD; Warren B. Shapiro, MD

Arch Intern Med. 1981;141(12):1652-1656.

Abstract
• In a previous prospective study, we reported that infusion intravenous pyelography (IVP) in 40 patients with chronic renal insufficiency resulted in acute renal failure (ARF) in 28 patients (70%). In an attempt to prevent this complication, we have evaluated the conditions of another group of 37 patients with chronic renal insufficiency treated in a similar manner except that each patient received 250 mL of 20% mannitol 60 minutes after infusion of the IVP dye (diatrizoate sodium, 300 mL of a 30% solution). These patients were similar to those in the previous study with regard to age, sex, renal function, and incidence of diabetes. Only eight (22%) of the 37 patients had ARF develop after infusion IVP in this study. This incidence was significantly lower compared with 70% in the previous study. We conclude that administration of hypertonic mannitol 60 minutes after administration of the radiographic contrast material is highly effective in preventing ARF after infusion IVP in patients with chronic renal insufficiency.

(Arch Intern Med 1981;141:1652-1656)

Author Affiliations
From the Division of Nephrology, Brookdale Hospital Medical Center, Brooklyn, NY.

Footnotes
Accepted for publication Nov 14, 1980.

Read in part before the annual meeting of the American Federation for Clinical Research, Washington, DC, May 6, 1979.

Reprint requests to Division of Nephrology, Brookdale Hospital Medical Center, Linden Boulevard and Brookdale Plaza, Brooklyn, NY 11212 (Dr Porush).

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