Is mannitol safe for patients with intracerebral hemorrhages? Renal considerations

Objectives: Mannitol, a drug widely used to decrease intracranial pressure, can cause renal failure. The goal of this study is to determine the renal safety of mannitol therapy in patients with intraparenchymal hemorrhages. Material and Methods: 51 patients with intracerebral hemorrhages were treated with mannitol according to guideline of American Heart Association. Serum urea and creatinine levels were measured before mannitol administration and on the 2nd, 5th and 14th day. Results: Transient elevation of urea and creatinine concentration was noticed, however, none of patients developed anuria or oliguria. Conclusions: Our study points out safety of mannitol therapy under control of osmolality, although control of urea and creatinine concentrations in special group of patients (persons with history of renal failure or diabetes) should be considered.