Tubular Alterations Produced by Osmotic Diuresis with Mannitol
Authors: VINCENT A. DISCALA
Journal: Annals of Internal Medicine (1965)

Article1 November 1965Tubular Alterations Produced by Osmotic Diuresis with MannitolVINCENT A. DISCALA, M.D., WILLY MAUTNER, M.D., JAY A. COHEN, M.D., MARVIN F. LEVITT, M.D., JACOB CHURG, M.D., STUART L. YUNIS, M.D.VINCENT A. DISCALA, M.D.Search for more papers by this author, WILLY MAUTNER, M.D.Search for more papers by this author, JAY A. COHEN, M.D.Search for more papers by this author, MARVIN F. LEVITT, M.D.Search for more papers by this author, JACOB CHURG, M.D.Search for more papers by this author, STUART L. YUNIS, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-63-5-767 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptMannitol, a polyhydric alcohol of the sugar mannose, is poorly metabolized by the body (1) and is poorly reabsorbed by the renal tubules (2). It was introduced to the renal physiology laboratory in 1940 as an agent for the measurement of glomerular filtration rate (GFR) (2) and was first used as an osmotic diuretic in 1948 (3). A report in 1960 that osmotic diuresis prevented acute renal failure after aortic cross-clamping popularized the use of mannitol as a therapeutic agent (4-6). Since then it has been used extensively as an osmotic diuretic in the treatment of many varied clinical states,...References1. ELLISKRANTZ FWJC: Sugar alcohols: XXII. Metabolism and toxicity studies with mannitol and sorbitol in man and animals. J. Biol. Chem. 141: 147, 1941. CrossrefGoogle Scholar2. SMITHFINKELSTEINSMITH WWNHW: Renal excretions of hexitols (sorbitol, mannitol and dulcitol) and their derivatives (sorbitan, isomannide and sorbide) and of endogenous creatinine-like chromogen in dog and man. J. Biol. Chem. 135: 231, 1940. CrossrefGoogle Scholar3. WESSONANSLOW LGWP: Excretion of sodium and water during osmotic diuresis in the dog. 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J. Med. 270: 183, 1964. CrossrefMedlineGoogle Scholar26. GOODMANCOHENLEVITTKAHN BJAMFM: Renal concentration in the normal dog: effect of an acute reduction in salt excretion. Amer. J. Physiol. 206: 1123, 1964. CrossrefMedlineGoogle Scholar27. LEVITTLEVYPOLIMEROS MFMSD: The effect of a fall in filtration rate on solute and water excretion in hydropenic man. J. Clin. Invest. 38: 463, 1959. CrossrefMedlineGoogle Scholar28. SMITH HW: The Kidney, Structure and Function in Health and Disease. Oxford University Press, New York, 1951, p. 167. Google Scholar29. ORLOFFWALSERKENNEDYBARTTER JMTJFC: Hyponatremia. Circulation 19: 284, 1959. CrossrefMedlineGoogle Scholar30. SCHWARTZRELMAN WBAS: Metabolic and renal studies in chronic potassium depletion resulting from overuse of laxatives. J. Clin. Invest. 32: 258, 1953. CrossrefMedlineGoogle Scholar31. RELMANSCHWARTZ ASWB: The nephropathy of potassium depletion. New Eng. J. Med. 255: 195, 1956. CrossrefMedlineGoogle Scholar32. BIAVADYRDAGENESTBENCOSME CGIJSA: Kaliopenic nephropathy. A correlated light and electron microscopic study. Lab. Invest. 12: 443, 1963. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: New York, New YorkFrom the Division of Renal Diseases, Department of Medicine and Department of Pathology, the Mount Sinai Hospital, New York, N. Y.This investigation was supported by grants HT 5505 and HE 06095, the National Heart Institute, Bethesda, Md., and grant AM 00918, National Institute for Arthritis and Metabolic Diseases, National Institutes of Health, U. S. Public Health Service, Bethesda, Md.Requests for reprints should be addressed to Vincent A. DiScala, M.D., U.S. Public Health Service Hospital, Staten Island, N. Y. 10304. 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