LOW molecular weight dextran (LMWD) has been advocated in the treatment of numerous clinical conditions in which local or generalized rheological disturbances play a role. In some of these conditions, such as acute lower extremity ischemia or acute myocardial infarction, the rheological disturbance may last for days or weeks and effective therapy must be prolonged.
Gelin and co-workers1 studied the electrolyte changes in humans after a single injection of LMWD in dextrose. He concluded that LMWD caused a marked diuresis during infusion with an increase of potassium excretion and decrease of sodium and chloride excretion in the urine. He postulated that LMWD caused a mobilization of electrolytes from the extracellular fluid with reduction of extracellular osmolarity. He also theorized that LMWD may act as an osmotic diuretic, a belief effectively challenged by Bergentz et al2 and Rabelo et al.3
We have been concerned that continued LMWD therapy