Diuretics are routinely prescribed in critically ill patients but significant variation in practice exists. In this article, we summarize current data relevant to diuretic prescribing.

What are the indications for diuretics in critically ill patients?
Diuretics are first-line therapy to remove excess fluid, as monotherapy or in combination using loop diuretics, carbonic anhydrase inhibitors, thiazides, and thiazide-like drug classes.

Mineralocorticoid receptor antagonists(MRAs) are used less frequently but may be prescribed to offset adverse effects of other diuretics (e.g. for hypokalemia due to loop diuretics).

Common indications for diuretics in critically ill patients include: (i) conditions where fluid accumulation negatively impacts organ function; (ii) situations where continued fluid administration is necessary despite risk of fluid accumulation and (iii) adjunctive management of hypertension.

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