Mannitol induced AKI

Q: Mannitol induced Acute Kidney Injury (AKI) can be made rapidly reversible by hemodialysis (HD)?

A) True

B) False

Answer: A

Patients who receive excessive amount of mannitol may develop AKI particularly if plasma osmolal gap goes above 60 to 75 mosmol/kg or if when plasma mannitol concentration goes beyond 1100 mg/dL. This is also known as mannitol nephrotoxicity syndrome. Mannitol induced AKI is usually and by default reversible. Risk factors include CHF, diabetes, preexisting renal disease, concomitant use of nephrotoxic drugs and other diuretics. 

The time period of AKI can be shortened by HD. The half life of mannitol is around 36 hours, HD shorten it to only 6 hours. It may require only one or two sessions of HD.

#nephrology

#pharmacology

Reference:

Gadallah MF, Lynn M, Work J. Case report: mannitol nephrotoxicity syndrome: role of hemodialysis and postulate of mechanisms. Am J Med Sci 1995; 309:219.