In this trial of 92 patients with creatinine >1.7 mg/dl undergoing cardiac catheterization, they were randomized to saline hydration, or euvolemic forced diuresis (with saline, mannitol, and furosemide). The forced diuresis group had a significantly higher rate of CIN (50% vs 28%). The same study did a meta-analysis (including 2 other studies with a total of 251 patients) and found the relative risk of harm of forced diuresis (compared to saline hydration) was 2.15 (CI 1.37 to 3.37). Forced diuresis to prevent CIN is harmful (abstract).
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.