Manejo de la insuficiencia Renal Aguda con Furosemida a Dosis Altas

Abstract

Introduction: Acute renal failure (ARF), considered a condition characterized by a sudden decrease in renal function, is associated with high rates of morbidity and mortality in critically ill patients. In this sense, the initial therapeutic management is important, which should focus on optimizing the patient’s internal hemodynamics. To do this, a series of diuretic drugs are used in patients with a tendency to retain fluids. In this regard, furosemide is the most widely used diuretic, however, the therapeutic value of high-dose administration is not fully known. Objective: To present current scientific evidence on the management of ARF with furosemide in high doses. Materials and Methods: A methodological design of the descriptive non-experimental type was used, with the review of nine articles of the current scientific literature of the digital databases SciELO, PubMed, Cochrane, among others, to compile relevant information and achieve a better understanding of the topic. Results: Previous studies do not recommend the application of this treatment; however, four current studies show that furosemide at high doses in continuous infusion increases diuresis, the restoration of renal function, and the decrease in deaths. Conclusions: The evidence is controversial, the therapeutic strategy should be aimed at patients with ARF without severe symptoms, preferably in continuous infusion since it is beneficial, although in-depth studies are required to adequately validate the results and define the clinical applications. Keywords: AKI, high doses, furosemide, acute renal failure, oliguria