For a patient with persistent renal dysfunction post-furosemide therapy, which management strategy is recommended?

Increasing the furosemide dosing is a common strategy for managing persistent renal dysfunction, particularly in patients who may be experiencing fluid overload or heart failure symptoms. Furosemide, a loop diuretic, works by inhibiting sodium and chloride reabsorption in the ascending loop of Henle in the kidneys, which promotes diuresis and can help alleviate volume overload, a common issue in patients with renal dysfunction.

In cases where a patient has not responded adequately to furosemide, adjusting the dosage may be necessary to enhance its effectiveness in promoting urine output and managing fluid status. This approach is generally preferred before considering more invasive interventions or alternatives that may not address the underlying issue as effectively.

While dialysis is a critical treatment for severe renal impairment, especially when there is acute kidney injury or life-threatening electrolyte imbalances, it is usually reserved for cases where conservative measures, such as adjusting diuretics, do not yield improvements. Thus, increasing the furosemide dosage is often the first step in renal management for patients undergoing diuretic therapy.