Promotion of diuresis in the prevention and/or treatment of the oliguric phase of acute renal failure before irreversible oliguric renal failure becomes established.
For this indication, competent medicine agencies globally authorize below treatments:
50 - 200 g
From 50 To 200 g once every day
The general dose range for adults is 50 to 200 g mannitol (330 to 1320 ml) in a 24-hour period, with a dosage limit of 50 g mannitol (330 ml) on any one occasion. In most instances adequate response will be achieved at a dosage of 50 to 100 g mannitol/day (330 to 660 ml). The rate of administration is usually adjusted to maintain a urine flow of at least 30-50 ml per hour.
Only in emergency situations, the maximum infusion rate can be as high as 200 mg/kg infused over 5 minutes (see also test dose). After 5 minutes, the infusion rate should be readjusted to maintain a urine flow of at least 30-50 ml per hour, with a maximum dose of 200 g/24h.
Patients with marked oliguria or suspected inadequate renal function should first receive a test dose of approximately 200 mg mannitol/kg bw (body weight) (1.3 ml/kg) infused over a period of 3 to 5 minutes. For example in an adult patient with a body weight of 70 kg: approximately 100 ml of a 15% solution. The response to the test dose is considered adequate if at least 30-50 ml/hour of urine is excreted for 2-3 hours. If an adequate response is not attained, a further test dose may be given. If an adequate response to the second test dose is not attained, treatment with mannitol should be discontinued and the patient reassessed as established renal failure may be present.
This hypertonic solution should be administered via a large peripheral or, preferably, a central vein. Rapid infusion in peripheral veins may be harmful.