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Are diuretics helpful in acute renal failure?

Although widely used to treat acute renal failure, diuretics may actually be harmful. The results of this observational study demonstrated a higher risk of death and non-recovery of renal function when diuretics were initiated during the first week of hospitalization. It didn't matter whether a single or combination diuretic was used. A randomized controlled trial would better answer this question by minimizing the inherent flaws in an observational study. Although this study doesn't conclusively prove that diuretics cause poorer outcomes, it certainly raises the possibility and should prompt us to think twice before initiating diuretic therapy for acute renal failure.