The principal rationale for the use of diuretics in acute renal failure is to prevent complete renal shutdown. Whether renal failure is caused by some underlying disease or by drug-induced renal toxicity, the continued production of even a small amount of urine is probably important in reducing further kidney tubular damage. Most commonly employed are the osmotic diuretics, with intravenous mannitol generally being the agent of choice. Osmotic diuresis is possible only if glomerular damage, tubular damage, or both have not progressed too far.
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