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Other serious side effects may include worsening heart failure and kidney problems. [9] [6] It is unclear if use is safe in pregnancy. [9] Mannitol is in the osmotic diuretic family of medications and works by pulling fluid from the brain and eyes. [9] The discovery of mannitol is attributed to Joseph Louis Proust in 1806. [11]
Two examples are mannitol [2] and isosorbide. In the nephron, osmotic diuretics act at the portions of the nephron that are water-permeable. [3] Osmotic diuretics work by expanding extracellular fluid and plasma volume, therefore increasing blood flow to the kidney. This washes out the cortical medullary gradient in the kidney.
Responsible exogenous solutes include sucrose-containing IVIg, mannitol, dextran, contrast dye, and hydroxyethyl starch. Prevention includes standard preventions for iatrogenic kidney damage. Osmotic nephrosis is usually reversible but can lead to chronic kidney failure. [citation needed]
Glucose, like mannitol, is a sugar that can behave as an osmotic diuretic. Unlike mannitol, glucose is commonly found in the blood. However, in certain conditions, such as diabetes mellitus, the concentration of glucose in the blood (hyperglycemia) exceeds the maximum reabsorption capacity of the kidney. When this happens, glucose remains in ...
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Hospitalization and IV hydration should be the first step in any patient suspected of having myoglobinuria or rhabdomyolysis. The goal is to induce a brisk diuresis to prevent myoglobin precipitation and deposition, which can cause acute kidney injury. Mannitol can be added to assist with diuresis.