Loop diuretic therapy in acute and chronic renal failure

Abstract

The development of the powerful loop diuretics over the past 30 years has significantly improved the quality of life for patients with advanced chronic renal failure (CRF). The most recent of these drugs is torasemide. This review outlines its mode of action and its pharmacokinetics and pharmacodynamics in CRF. A personal view of the efficacy and usefulness of these drugs in CRF, CRF on dialysis, and in nephrotic syndrome is given. The role of loop diuretics in potential and/or established acute renal failure is unknown. Theoretical advantages are described, current knowledge reviewed, and an outline of a prospective study presently underway is given.