AUTHOR=Escudero Victor Joaquin , Mercadal Jordi , Molina-Andújar Alícia , Piñeiro Gaston J. , Cucchiari David , Jacas Adriana , Carramiñana Albert , Poch Esteban 

TITLE=New Insights Into Diuretic Use to Treat Congestion in the ICU: Beyond Furosemide

JOURNAL=Frontiers in Nephrology

VOLUME=2

YEAR=2022

URL=https://www.frontiersin.org/journals/nephrology/articles/10.3389/fneph.2022.879766

DOI=10.3389/fneph.2022.879766

ISSN=2813-0626

ABSTRACT=<p>Diuretics are commonly used in critically ill patients with acute kidney injury (AKI) and fluid overload in intensive care units (ICU), furosemide being the diuretic of choice in more than 90% of the cases. Current evidence shows that other diuretics with distinct mechanisms of action could be used with good results in patients with selected profiles. From acetazolamide to tolvaptan, we will discuss recent studies and highlight how specific diuretic mechanisms could help to manage different ICU problems, such as loop diuretic resistance, hypernatremia, hyponatremia, or metabolic alkalosis. The current review tries to shed some light on the potential use of non-loop diuretics based on patient profile and give recommendations for loop diuretic treatment performance focused on what the intensivist and critical care nephrologist need to know based on the current evidence.</p>