Skip to main content

Osmotic Diuretics: Mannitol

  • Chapter
Diuretics

Part of the book series: Handbook of Experimental Pharmacology ((HEP,volume 117))

Abstract

Osmotic diuretics are freely filterable, low molecular weight substances that due to their limited reabsorption and small size create an osmotic force in the tubular fluid sufficient to retard the reabsorption of fluids and solutes (notably NaCl) along the nephron. Thus, osmotic diuresis results in urinary loss of water and sodium.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Anon (1984) Guidelines for administration of intravenous medications to pediatric patients, 2nd edn. American Society of Hospital Pharmacists. Bethesda, MD

    Google Scholar 

  • Barry KC, Cohen A, Knochel JP, Whelan TJ, Beisel WR, Vargas CA, LeBlanc PC (1961) Mannitol infusion II. The prevention of acute functional renal failure during resection of an aneurysm of the abdominal aorta. N Engl J Med 264: 967–971

    Article  PubMed  CAS  Google Scholar 

  • Ben-Haim SA, Edoute Y, Hayam G, Better OS (1992a) Sodium modulates inotropic response to hyperosmolarity in isolated working rat heart. Am J Physiol 263 (Heart Circ Physiol 32):H1154-H1160

    PubMed  CAS  Google Scholar 

  • Ben-Haim SA, Hayam G, Edoute Y, Better OS (1992b) Effect of hypertonicity on contractility of isolated working rat left ventricle. Cardiovasc Res 26:379–382

    Article  PubMed  CAS  Google Scholar 

  • Berry AJ, Peterson ML (1981) Hyponatremia after mannitol administration in the presence of renal failure. Anesth Analg 60:165–167

    Article  PubMed  CAS  Google Scholar 

  • Better OS, Stein JH (1990) Early management of shock and prophylaxis of acute renal failure in traumatic rhabdomyolysis. N Engl J Med 322:825–829

    Article  PubMed  CAS  Google Scholar 

  • Better OS Jr, Gonick HC, Chapman LC, Varady PD, Kleeman CR (1966) Effect of urea-saline diuresis in renal clearance of calcium, magnesium, and inorganic phosphate in man. Proc Soc Exp Biol Med 121:592–596

    PubMed  CAS  Google Scholar 

  • Better CS, Zinman C, Reis DN, Har-Shai Y, Rubinstein I, Abassi Z (1991) Hypertonic mannitol ameliorates intracompartmental tamponade in model compartment syndrome in the dog. Nephron 58:344–346

    Article  PubMed  CAS  Google Scholar 

  • Blantz RC (1974) Effect of mannitol on glomerular ultrafiltration in the hydropenic rat. J Clin Invest 54:1135–1143

    Article  PubMed  CAS  Google Scholar 

  • Borges HF, Hocks J, Kjellstrand CM (1982) Mannitol intoxication in patients with renal failure. Arch Intern Med 142:63–66

    Article  PubMed  CAS  Google Scholar 

  • Braun WE, Lilienfield LS (1963) Renal hemodynamic effects of hypertonic mannitol infusions. Proc Soc Exp Biol Med 114:1–6

    PubMed  CAS  Google Scholar 

  • Brenner BM, Troy JL, Daugharty TM (1972) Pressures in cortical structures of the rat kidney. Am J Physiol 222:246–251

    PubMed  CAS  Google Scholar 

  • Buerkert J, Martin D, Prasad J, Trigg D (1981) Role of deep nephrons and the terminal collecting duct in a mannitol-induced diuresis. Am J Physiol 240 (Renal Fluid Electrolyte Physiol 9):F411-F422

    PubMed  CAS  Google Scholar 

  • Cloyd JC, Snyder BD, Cleeremans B, Bundlie SR, Blomquist CH, Lakatua TJ (1986) Mannitol pharmacokinetics and serum osmolality in dogs and humans. J Pharmacol Exp Ther 236:301–306

    PubMed  CAS  Google Scholar 

  • Collins GM, Wicomb WN (1992) New organ preservation solutions. Kidney Int 42(38):S197-S202

    Google Scholar 

  • Delmaestro RF, Thaw HH, Bjork J, Planker M, Arfors KE (1980) Free radicals as mediators of tissue injury. Acta Physiol Scand 492 [Suppl I]:43–57

    CAS  Google Scholar 

  • Domainque CM, Nye DH (1985) Hypotensive effect of mannitol administered rapidly. Anaesth Interns Care 13:134–136

    Google Scholar 

  • Duarte CG, Watson JF (1967) Calcium reabsorption in proximal tubule of the dog nephron. Am J Physiol 212:1355–1360

    PubMed  CAS  Google Scholar 

  • Etheredge EE, Levitin HL, Nakamura K, Glenn WWL (1965) Effect of mannitol on renal function during open-heart surgery. Ann Surg 161:53–62

    Article  PubMed  CAS  Google Scholar 

  • Flores J, DiBona DR, Beck CH, Leaf A (1972) The role of cell swelling in ischemic renal damage and the protective effect of hypertonic solute. J Clin Invest 51:118–126

    Article  PubMed  CAS  Google Scholar 

  • Fojas E, Schmid HE (1970) Renin release, renal autoregulation and sodium excretion in the dog. Am J Physiol 219:464–468

    PubMed  CAS  Google Scholar 

  • Franklin B, Lui J, Ginsberg-Fellner F (1982) Cerebral edema and ophthalmoplegia reversed by mannitol in a new case of insulin-dependent diabetes millitus. Pediatrics 69:87–90

    PubMed  CAS  Google Scholar 

  • Garcia-Dorado D, Theroux P, Munoz R, Alonso J, Elizaga J, Fernandez-Aviles F, Botas J, Solares J, Soriano J, Duran JM (1992) Favorable effects of hyperosmotic reperfusion on myocardial edema and infarct size. Am J Physiol 262:H17-H22

    PubMed  CAS  Google Scholar 

  • Gennari FJ, Kassirer JP (1974) Osmotic diuresis. N Engl J Med 291:714–720

    Article  PubMed  CAS  Google Scholar 

  • Gilman AG, Goodman LS, Rail TW, Murad F (eds) (1985) Goodman and Gilman’s the pharmacological basis of therapeutics, 7th edn. Macmillan, New York

    Google Scholar 

  • Goldberg M (1973) The renal physiology of diuretics. In: Orloff J, Berliner RW (eds) Handbook of physiology, renal physiology. American Physiological Society, Washington DC, pp 1003–1031

    Google Scholar 

  • Goldberg AH, Lilienfield LS (1965) Effects of hypertonic mannitol on renal vascular resistance. Proc Soc Exp Biol Med 119:635–642

    PubMed  CAS  Google Scholar 

  • Goldberg M, Ramirez MA (1967) Effects of saline and mannitol diuresis on the renal concentrating mechanism in dogs: alterations in renal tissue solutes and water. Clin Sci 32:475–493

    PubMed  CAS  Google Scholar 

  • Goldberg M, McCurdy D, Ramirez M (1965) Differences between saline and mannitol diuresis in the hydropenic man. J Clin Invest 44:182–192

    Article  PubMed  CAS  Google Scholar 

  • Grabie MT, Gipstein RM, Adams DA, Hepner W (1981) Contraindications for mannitol in aphakic glaucoma. Am J Ophthalmol 91:265–267

    PubMed  CAS  Google Scholar 

  • Greger R (1985) Ion transport mechanism in thick ascending limb of Henle’s loop of mammalian nephrons. Physiol Rev 65:760–797

    PubMed  CAS  Google Scholar 

  • Johnston IH, Paterson A, Harper AM, Jennet WB (1972) The effect of mannitol on ICP and CBF. In: Brock M, Dietz H (eds) Intracranial pressure. Springer, Berlin, Heidelberg, New York, pp 176–180

    Chapter  Google Scholar 

  • Johnston PA, Bernard DB, Perrin NS, Levinsky NG (1981) Prostaglandins mediate the vasodilatory effect of mannitol in the hypoperfused rat kidney. J Clin Invest 68:127–133

    Article  PubMed  CAS  Google Scholar 

  • Lilien OM (1973) The paradoxical reaction of renal vasculature to mannitol. Invest Urol 10:346–353

    PubMed  CAS  Google Scholar 

  • Lillien OM, Jones SG, Mueller CB (1963) The mechanism of mannitol diuresis. Surg Gynecol Obstet 117:221–228

    Google Scholar 

  • Lucas SK, Gardner TJ, Flaherty JT, Bulkley BH, Elmer EB, Gott VL (1980) Beneficial effects of mannitol administration during reperfusion after ischemic arrest. Circulation 62 [Suppl I]:34–41

    CAS  Google Scholar 

  • Madsen PO, Knuth OE, Wagenknecht LV, et al. (1970) Induction of diuresis following transurethral resection of the prostate. J Urol 104:735–738

    PubMed  CAS  Google Scholar 

  • Maesaka JK, Bergen ML, Bornia ME, Abramson RB, Levitt MF (1976) Effect of mannitol on phosphate transport in intact and acutely thyroparathyroidectomized rats. J Lab Clin Med 87:680–691

    PubMed  CAS  Google Scholar 

  • Magovern GJ Jr, Boiling SF, Casale AS, Bulkley BH, Gardner TJ (1984) The mechanism of mannitol in reducing ischemic injury: hyperosmolarity or hydroxyl scavenger? Circulation 70 [Suppl I]:91–95

    Google Scholar 

  • Manninen PH, Lam AM, Gelb AW, Brown SC (1987) The effect of high-dose mannitol on serum and urine electrolytes and osmolality in neurosurgical patients. Can J Anaesth 34:442–446

    Article  PubMed  CAS  Google Scholar 

  • Malnic G, Klose R, Griebish G (1966) Micropuncture study of the distal tubular potassium and sodium transport in the rat nephron. Am J Physiol 211:529–547

    PubMed  CAS  Google Scholar 

  • Malvin RL, Wilde WS (1959) Washout of renal countercurrent Na gradient by osmotic diuresis. Am J Physiol 197:177–180

    PubMed  CAS  Google Scholar 

  • Mason J, Joeris B, Welsch J, Kriz W (1989) Vascular congestion in ischemic renal failure: the role of cell swelling. Miner Electrolyte Metab 15:114–124

    PubMed  Google Scholar 

  • Miller JD (1973) The effects of hyperbaric oxygen at 2 and 3 atmospheres absolute and intravenous mannitol on experimentally increased intracranial pressure. Eur Neurol 10:1–11

    Article  PubMed  CAS  Google Scholar 

  • Morris CR, Alexander EA, Bruns FJ, Levinsky NG (1972) Restoration and maintenance of glomerular filtration by mannitol during hypoperfusion of the kidney. J Clin Invest 51:1555–1564

    Article  PubMed  CAS  Google Scholar 

  • Myers BD (1990) Nature of postischaemic renal injury following aortic or cardiac surgery. In: Bihari D, Nield G (eds) Acute renal failure in the intensive therapy unit. Springer Verlag, London, pp 167–180

    Chapter  Google Scholar 

  • Nutman J, Hill JH (1992) Treatment of water intoxication with mannitol (letter). Am J Dis Child 146:1130–1131

    PubMed  CAS  Google Scholar 

  • Ott CE, Navar LG, Guyton AC (1971) Pressures in static and dynamic states from capsules implanted in the kidney. Am J Physiol 221:394–400

    PubMed  CAS  Google Scholar 

  • Peters G, Brunner H (1963) Mannitol diuresis in hemorrhagic hypotension. Am J Physiol 204:555–562

    PubMed  CAS  Google Scholar 

  • Reilly MJ (ed) (1976) Pocket consultant: diuretics. Am Soc Hosp Pharm, Washington

    Google Scholar 

  • DC Reynolds JEF (ed) (1990) Martindale: The Extra Pharmacopoeia (CD-ROM Version). Micromedex, Denver

    Google Scholar 

  • Rubinstein I, Kerem D, Melamed Y, Better OS (1993) Hyperbaric 02 (HBO) & 20% I.V. mannitol (M) enhance recovery from muscular crush injury. In: Reinertsen RE, Brubakk AO, Bolstad G (eds) Proceedings of the 19th Annual Meeting of the European Underwater Biomedical Society on Diving and Hyperbaric Medicine, Trondheim, Norway, 17–20 Aug 1993, pp 137–141

    Google Scholar 

  • Seely JF, Dirks JH (1969) Micropuncture study of hypertonic mannitol diuresis in the proximal and distal tubule of the dog kidney. J Clin Invest 48:2330–2340

    Article  PubMed  CAS  Google Scholar 

  • Selkurt EE (1945) Changes in renal clearance following complete ischemia of kidney. Am J Physiol 144:395–403

    CAS  Google Scholar 

  • Sonnenberg H (1978) Effects of furosemide, acetazolamide, and mannitol on medullary collecting-duct function in the rat kidney. Pflugers Arch 373:113–123

    Article  PubMed  CAS  Google Scholar 

  • Stahl WM (1965) Effect of mannitol on the kidney. Changes in intrarenal hemodynamics. N Engl J Med 272:381–386

    Article  CAS  Google Scholar 

  • Stinebaugh BJ, Bartow SA, Eknoyan G, Martinez-Maldonado M (1971) Renal handling of bicarbonate: effect of mannitol diuresis. Am J Physiol 220:1271–1274

    PubMed  CAS  Google Scholar 

  • Strauss MB, Hargens AR, Gershuni DH, Hart GB, Akeson WH (1986) Delayed use of hyperbaric oxygen for treatment of a model anterior of compartment syndrome. J Orthop Res 4:108–111

    Article  PubMed  CAS  Google Scholar 

  • Valdes ME, Landau SE, Shah DM, Newell JC, Scovill WA, Stratton H, Rhodes GR, Powers Jr SR (1979) Increased glomerular filtration rate following mannitol administration in man. J Surg Res 26:473–477

    Article  PubMed  CAS  Google Scholar 

  • Vander AJ, Miller R (1964) Control of renin secretion in the anesthetized dog. Am J Physiol 207:537–546

    PubMed  CAS  Google Scholar 

  • Velasquez MT, Notargiacomo AV, Cohn JN (1973) Comparative effects of saline and mannitol on renal cortical blood flow and volume in the dog. Am J Physiol 224:322–327

    PubMed  CAS  Google Scholar 

  • Warren SE, Blantz RC (1981) Mannitol. Arch Intern Med 141:493–497

    Article  CAS  Google Scholar 

  • Weaver A, Sica D (1987) Mannitol-induced acute renal failure. Nephron 45:233–235

    Article  PubMed  CAS  Google Scholar 

  • Wesson LG (1962) Magnesium, calcium and phosphate excretion during osmotic diuresis in the dog. J Lab Clin Med 60:422–432

    PubMed  CAS  Google Scholar 

  • Wesson LG Jr, Anslow WP Jr (1948) Excretion of sodium and water during osmotic diuresis in the dog. Am J Physiol 153:465–474

    PubMed  CAS  Google Scholar 

  • Wesson LG Jr, Anslow WP (1952) Effect of osmotic and mercurial diuresis on simultaneous water diuresis. Am J Physiol 170:255–269

    PubMed  Google Scholar 

  • Williams TF, Hollander W Jr, Strauss MB, Rossmeisl EC, McLean R (1955) Mechanism of increased renal sodium excretion following mannitol infusion in man. J Clin Invest 34:595–601

    Article  PubMed  CAS  Google Scholar 

  • Windhager EE, Giebisch G (1961) Micropuncture study of renal tubular transfer of sodium chloride in the rat. Am J Physiol 200:581–590

    PubMed  CAS  Google Scholar 

  • Wong NLM, Quamme GA, Sutton RAL (1979) Effects of mannitol on water and electrolyte transport in the dog kidney. J Lab Clin Med 94:683–692

    PubMed  CAS  Google Scholar 

  • Yamasaki Y, Nishiuchi T, Kojima A, Saito H, Saito S (1988) Effects of an oral water load and intravenous administration of isotonic glucose, hypertonic saline, mannitol and furosemide on the release of atrial natriuretic peptide in men. Acta Endocrinol (Copenh) 119:269–278

    CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1995 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Better, O.S., Rubinstein, I., Winaver, J. (1995). Osmotic Diuretics: Mannitol. In: Greger, R.F., Knauf, H., Mutschler, E. (eds) Diuretics. Handbook of Experimental Pharmacology, vol 117. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-79565-7_12

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-79565-7_12

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-79567-1

  • Online ISBN: 978-3-642-79565-7

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics