Mannitol in kidney diseases: Does it have any role in current nephrology?

Abstract

Mannitol has been used for many years as an osmotic agent in the management of various medical conditions, including cerebral edema and glaucoma. However, its use has been associated with complications such as changes in blood volume and the internal milieu, leading to its progressive substitution by hypertonic saline solutions. In addition, it has been used to prevent and manage acute kidney injury, particularly in surgical patients, and to preserve diuresis in conditions that may promote acute tubular necrosis. Mannitol has also been used in hemodialysis patients to prevent and treat acute complications such as intradialytic hypotension, cramps, and dialysis disequilibrium syndrome. However, most of the studies are retrospective and of low power. Despite the known associated complications, mannitol continues to be used in many centers due to its availability and easy administration. This review aims to evaluate the efficacy and safety of mannitol in managing kidney diseases.