It is important to correct pre-renal causes of oliguria before resorting to diuretic use. Diuretics do not prevent renal failure but may convert oliguric to polyuric renal failure.

If there is inadequate glomerular filtration, mannitol is retained and passes to the extracellular fluid to promote oedema formation.

Bumetanide may be used in porphyria where thiazides and other loop diuretics are contraindicated.

Potassium sparing diuretics should be avoided with ACE inhibitors as there is an increased risk of hyperkalaemia.


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