[Mechanism of the therapeutic effect of furosemide and mannitol in hemorrhagic shock and developing acute renal insufficiency]

Abstract

Acute hypotension leads to the development of anuria, almost complete stoppage of the cortical nephron filtration with blood retransfusion failing to restore the upset functions. But against background of preliminary administered diuretics the blood retransfusion renews filtration and restores diuresis. Preliminary administration of diuretics prevents collapse of the proximal tubules, their administration after blood losses increases the tubular pressure and prevents obstruction of the nephron. Under the effect of diuretics the oxygenation of deep-seated segments of the kidney substantially gains in strength due to an increasing renal blood circulation and diminished vasoconstriction. Diuretics increase the oxidative phosphorylation in the cells of the renal epithelium, help augment accumulation of calcium by renal mitochondria and prevent the development of irreversible hypoxic shifts. Combined administration of furosemide and mannitol represents an effective means of prevention and early treatment of acute renal insufficiency.