Another traditional but controversial practice is the
use of diuretics to maintain or increase urine output and
therefore promote the excretion of uric acid and phosphate
(Coiffier et al., 2008). However, the use of diuretics
is contraindicated in patients with hypovolemia or
obstructive uropathy (Coiffier et al., 2008; Tazi et al.,
2011). There is some evidence that furosemide and mannitol
(which are loop diuretics) can inhibit sodium and
chloride reabsorption. As in the case of alkalinization,
furosemide can lead to increased uric acid or calcium precipitates
in the renal tubules, which may contribute to
additional uric acid neuropathy (Mughal et al., 2010).