We have previously reported that mannitol strikingly increases blood flow to rat kidneys hypoperfused at 35-40mm Hg. This vasodilator effect is not due to volume expansion or alterations in plasma osmolality. We have tested the hypothesis that the vasodilatory effect of mannitol in the ischemic rat kidney is mediated by one of the vasoactive renal hormone systems: renin-angiotension, kallikrein-kinin, or prostaglandins. Rats were infused with 5% mannitol in 0.9% saline to 3-5% of body weight. In agreement with our previous studies, RBF increased 1.3 +/- 0.1 ml/min despite maintenance of perfusion pressure at 35-40 mm Hg. The cyclooxygenase inhibitors, meclofenamate and indomethacin had no effect on renal blood flow (RBF) in hypoperfused kidneys. However, in rats pretreated with these inhibitors, expansion with mannitol increased RBF by only 0.37 +/- 0.02 ml/min, 28% of the response in the untreated group (p less than 0.001). Infusion of prostacyclin (PGI2) into the renal artery during reduced perfusion resulted in an increase in RBF of 1.0 +/- 0.1 ml/min. Subsequent expansion with mannitol increased RBF by only 0.5 +/- 0.1 ml/min more, less than one-half of the effect of mannitol in a concurrent group of rats not treated with PGI2. Unlike PGI2 prostaglandin E2 had only a minimal vasodilator effect during hyperperfusion. Imidazole, an inhibitor of thromboxane synthesis, did not alter RBF or renal vascular resistance during hypoperfusion. Treatment of rats during hypoperfusion. with the angiotensin-converting enzyme (kininase II) inhibitor teprotide increased RBF by 1.1 +/- 0.3 ml/min. However, teprotide did not alter the vascular response to mannitol: RBF increased 1.2 +/- 0.1 ml/min more when mannitol was infused into teprotide-treated rats. The renal vascular response to mannitol was not altered by treatment with aprotinin, an inhibitor of the kallikrein-kinin system. Aprotinin was ineffective whether given before or after the vascular response to mannitol was established. We conclude that the vasodilator response to mannitol in the ischemic rat kidney is mediated in large part by increased prostaglandin (PGI2) activity. The failure of converting enzyme inhibition and aprotinin to block the vasodilator response to mannitol is evidence against a role for the renin-angiotension or kallikreinkinin systems in mediating the vasodilator response.
P A Johnston, D B Bernard, N S Perrin, N G Levinsky
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Effect of intravenous mannitol on renal function in patients undergoing laparoscopic nephron-sparing surgery: a randomized, double-blinded trial.
Cheriyan A, Mariappan R, Jeyaseelan L, Samuel P, Annadurai S, George AJP, Devasia A, Kumar S, John NT |
International urology and nephrology | 2025 |
Ureaplasma urealyticum infection following organ transplantation: a case report and narrative review
Zhang H, Yang L |
Renal Failure | 2024 |
Impact of Mannitol Administration on Postoperative Renal Function After Robot-Assisted Partial Nephrectomy
Taniguchi K, Taniguchi T, Muraoka K, Nishikawa K, Ikehata Y, Setoguchi K, Oka S, Ebara S, Fujisaki A, Makiyama K, Inoue T, Kitamura H, Saito K, Urakami S, Yoneda T, Koie T |
Journal of Clinical Medicine | 2024 |
Response to a Randomized Trial on Mannitol Use During Partial Nephrectomy
P Lewicki, SP Basourakos, Y Qiu, C Arenas-Gallo, DS Scherr, LE Ponsky, JE Shoag |
JAMA SURG | 2021 |
The use of mannitol in partial nephrectomy for renal function preservation: meta-analysis and systematic review of comparative studies
KC Rivera, RD Tiangco, LK Aba, JL Ongkeko, JS Dy, ME Chua |
Journal of Clinical Urology | 2021 |
The association between intraoperative urine output and postoperative acute kidney injury differs between partial and radical nephrectomy
M Hur, SK Park, S Yoo, SN Choi, CW Jeong, WH Kim, JT Kim, C Kwak, JH Bahk |
Scientific Reports | 2019 |
Use of Mannitol for Ischemia Reperfusion Injury in Kidney Transplant and Partial Nephrectomies—Review of Literature
JA Lugo-Baruqui, R Ayyathurai, A Sriram, KD Pragatheeshwar |
Current Urology Reports | 2019 |
Examining Mannitol Use in Kidney Cancer Surgery: A Cautionary Tale of Extrapolated Surgical Data
SM Nair, NE Power, JA Coleman |
European Urology Focus | 2019 |
Mannitol for the Prevention of Peri-Operative Acute Kidney Injury: A Systematic Review
J Waskowski, CA Pfortmueller, G Erdoes, R Buehlmann, AS Messmer, MM Luedi, J Schmidli, JC Schefold |
European Journal of Vascular and Endovascular Surgery | 2019 |
Intravenous Mannitol Versus Placebo During Partial Nephrectomy in Patients with Normal Kidney Function: A Double-blind, Clinically-integrated, Randomized Trial
M Spaliviero, NE Power, KS Murray, DD Sjoberg, NE Benfante, ML Bernstein, J Wren, P Russo, JA Coleman |
European Urology | 2018 |
Seldin and Giebisch's The Kidney
CJ Cooper, LD Dworkin, WL Henrich |
Seldin and Giebisch's The Kidney | 2013 |
Mannitol has no impact on renal function after open partial nephrectomy in solitary kidneys: No impact of mannitol
K Omae, T Kondo, T Takagi, J Iizuka, H Kobayashi, Y Hashimoto, K Tanabe |
International Journal of Urology | 2013 |
Mannitol and Renal Dysfunction after Endovascular Aortic Aneurysm Repair Procedures: A Randomized Trial
K Kalimeris, N Nikolakopoulos, M Riga, K Christodoulaki, KG Moulakakis, C Dima, C Papasideris, T Sidiropoulou, G Kostopanagiotou, A Pandazi |
Journal of Cardiothoracic and Vascular Anesthesia | 2013 |
Mannitol increases renal blood flow and maintains filtration fraction and oxygenation in postoperative acute kidney injury: a prospective interventional study
G Bragadottir, B Redfors, SE Ricksten |
Critical Care | 2012 |
Perioperative Medicine
SL Cohn |
Perioperative Medicine | 2011 |
Miller's Anesthesia
RN Sladen |
Miller's Anesthesia | 2010 |
Effects of mannitol alone and mannitol plus furosemide on renal oxygen consumption, blood flow and glomerular filtration after cardiac surgery
B Redfors, K Swärd, J Sellgren, SE Ricksten |
Intensive Care Medicine | 2008 |
Therapy in Nephrology & Hypertension
DH Ellison, CS Wilcox |
Therapy in Nephrology & Hypertension | 2008 |
Response of Bone Subjected to Optimized High Dose Irradiation
HW Burgess, J Mackrell, D Toms, A Karunanidhi, S Vaidya, JO Hollinger, TA Grieb, GP Bertenshaw |
Journal of Biomaterials Applications | 2008 |
Fluids for Prevention and Management of Acute Kidney Injury
JA Kellum, J Cerda, LJ Kaplan, MK Nadim, PM Palevsky |
The International Journal of Artificial Organs | 2008 |
Perioperative fluid management in renal transplantation: a narrative review of the literature
P Schnuelle, FJ van der Woude |
Transplant International | 2006 |
Critical Heart Disease in Infants and Children
BA Fivush, AM Neu, R Parekh, LG Maxwell, LC Racusen, JR White, DG Nichols |
Critical Heart Disease in Infants and Children | 2006 |
The hydroosmotic response of frog urinary bladder to serosal hypertonicity is dependent on adenylate cyclase for its maintenance and affected by [Cl − ] o changes
AT Hanna-Mitchell, EM Gebruers |
American Journal of Physiology - Regulatory, Integrative and Comparative Physiology | 2006 |
Acute Renal Failure in Children: Aetiology and Management
G Filler |
Pediatric Drugs | 2001 |
Effects of Radiocontrast, Mannitol, and Endothelin on Blood Pressure and Renal Damage in the Aging Male Spontaneously Hypertensive Rat
CG Duarte, J Zhang, S Ellis |
Investigative Radiology | 1999 |
Physiological and morphological effects of perfusing isolated rat kidneys with hyperosmolal mannitol solutions
Lindstrom, Ronnstedt, Jaremko, Haraldsson |
Acta Physiologica Scandinavica | 1999 |
Effects of Radiocontrast, Mannitol, and Endothelin on Blood Pressure and Renal Damage in the Aging Male Spontaneously Hypertensive Rat:
CG Duarte, J Zhang, S Ellis |
Investigative Radiology | 1999 |
Critical Care Nephrology
C Ronco, R Bellomo |
1998 | |
Ecstasy-induced rhabdomyolysis and its role in the development of acute renal failure
M Cunningham |
Intensive and Critical Care Nursing | 1997 |
Mannitol therapy revisited (1940–1997)
OS Better, I Rubinstein, JM Winaver, JP Knochel |
Kidney International | 1997 |
Acute Renal Failure
R Thadhani, M Pascual, JV Bonventre |
New England Journal of Medicine | 1996 |
Does Mannitol Save the Kidney?:
S Gelman |
Anesthesia & Analgesia | 1996 |
Preventing the inflammatory response to open-heart surgery: The role of aprotinin and other protease inhibitors
D Royston |
International Journal of Cardiology | 1996 |
Acute Renal Failure in the Critically Ill
R Bellomo, C Ronco |
1995 | |
Renal Failure
JG Abuelo |
Renal Failure | 1995 |
Diuretics
BD Rose |
Kidney International | 1991 |
Mannitol Stimulates Atrial Natriuretic Peptide Release in Humans
BR Kurnik, LS Weisberg, AD Askenase, PB Kurnik |
American Journal of Kidney Diseases | 1991 |
Suppression of Renal vein Renin Profiles by Mannitol Prophylaxis: Implications in the Evaluation of Renovascular Hypertension
RL Benz, BP Teehan, MH Sigler, GS Gilgore, CR Schleifer |
American Journal of Kidney Diseases | 1991 |
Generation of Free Oxygen Radicals and the Toxicity of Hemoglobin Solutions
J Simoni, M Feola, PC Canizaro |
Artificial Cells, Blood Substitutes and Biotechnology | 1990 |
Acute renal failure with selective medullary injury in the rat
SN Heyman, M Brezis, CA Reubinoff, Z Greenfeld, C Lechene, FH Epstein, S Rosen |
Journal of Clinical Investigation | 1988 |
Common Perioperative Problems and the Anaesthetist
GM Woerlee |
1988 | |
Acute renal failure in the intensive care unit. Part 2
HL Corwin, JV Bonventre |
Intensive Care Medicine | 1988 |
Prostaglandins and other arachidonic acid metabolites in the kidney
D Schlondorff, R Ardaillou |
Kidney International | 1986 |
Eicosanoids in experimental and human renal disease
JE Stork, MA Rahman, MJ Dunn |
The American Journal of Medicine | 1986 |
Diuretic use in critical care
RG Narins, P Chusid |
The American Journal of Cardiology | 1986 |
Diuretic therapeutics in the pediatric patient
MK Witte, JE Stork, JL Blumer |
The American Journal of Cardiology | 1986 |
Southwestern Internal Medicine Conference: Drug Therapy in the Management of Acute Renal Failure
RE Cronin |
The American Journal of the Medical Sciences | 1986 |
Prevention of acute tubular necrosis in cadaveric kidney transplantation by the combined use of mannitol and moderate hydration
RG Tiggeler, JH Berden, AJ Hoitsma, RA Koene |
Annals of Surgery | 1985 |
Schock
W Bleifeld, WD Bussmann, H Djonlagic, U Geßler, UF Gruber, H Herzog, W Kupper, HG Lasch, G Müller-Esch, G Oehler, G Paumgartner, A Perruchoud, G Riecker, HP Schuster, PC Scriba, D Seybold |
1984 | |
Inhibition of soybean lipoxygenase by mannitol
AR Morrison, TS Winokur, WA Brown |
Biochemical and Biophysical Research Communications | 1982 |
Contemporary Nephrology
S Klahr, SG Massry |
1981 | |
Anesthesiology
SH Ngai, EM Papper |
New England Journal of Medicine | 1963 |