Acute renal failure following massive mannitol infusion and enalapril treatment

F. Nakhoul, O. S. Better

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8 Scopus citations


We report a patient with reversible acute oligoanuric renal failure. Intravenous mannitol 25% was infused to treat intracranial edema, during chronic administration of ACE inhibitors for arterial hypertension. Serum creatinine level rose to 5.6 mg/dl from a previous value of 1.2 mg/dl. Measured and calculated serum osmolalities were 310 and 280 mosm/kg respectively. We postulate that the association of afferent arteriolar constriction due to mannitol induced tubulo-glomerular imbalance and efferent dilatation due to ACE inhibitors provoked a sharp reduction in glomerular filtration rate. Alternatively, mannitol infusion may have caused tubular cell swelling with luminal obstruction.

Original languageEnglish
Pages (from-to)118-120
Number of pages3
JournalClinical Nephrology
Issue number2
StatePublished - 1995
Externally publishedYes


  • Acute renal failure
  • Enalapril
  • Mannitol


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