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In hypervolaemic patients there are signs of fluid overload e.g. raised JVP with systemic or pulmonary oedema and hypertension.
The aim of management is to remove excess fluid volume. Large doses of diuretics e.g. frusemide 180 mg i.v. or 500-1000 mg orally may be tested.
If these measures are not successful in producing diuresis and the patient has clinical or radiological evidence of pulmonary oedema then the fluid must be removed by dialysis or ultrafiltration.
Once the fluid balance has been corrected then the patient is considered as normovolaemic with acute renal failure.
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