Osmotic diuretic treatment of refractory edema.

Many patients with edema of congestive cardiac failure, nephrosis, and cirrhosis become refractory to all diuretic therapy. Theoretically, the use ia adequate dosage of osmotic diuretics whose action is dependent upon physical factors should augment sodium, chloride, and water excretion from whatever level exists prior to their use. In refractory edema, the effect of other diuretics (via alteration of the imetabolie, actively resorbing mechanisms of the tubular cells) on tubular rejection of sodium, chloride, and water should be increased by osmotic diuretics. Mannitol was administered intravenously in large doses to test the effectiveness of osmotic diuretics in refractory edema.