The furosemide stress test for prediction of worsening acute kidney injury in critically ill patients: A multicenter, prospective, observational study.
J Crit Care
; 52: 109-114, 2019 08.
Article
de En
| MEDLINE
| ID: mdl-31035185
ABSTRACT
PURPOSE:
To validate the furosemide stress test (FST) for predicting the progression of acute kidney injury (AKI). MATERIALS ANDMETHODS:
We performed a multicenter, prospective, observational study in patients with stage I or II AKI. The FST (1â¯mg/kg for loop diuretic naïve patients and 1.5â¯mg/kg in patients previously exposed to loop diuretics) was administered. Subsequent urinary flow rate (UFR) recorded and predictive ability of urinary output was measured by the area under the curve receiver operatic characteristics (AuROC). Primary outcome was progression to Stage III AKI. Secondary outcomes included in-hospital mortality and adverse events.RESULTS:
We studied 92 critically ill patients. 23 patients progressed to stage III AKI and had significantly lower UFR (pâ¯<â¯0.0001). The UFR during the first 2â¯h was most predictive of progression to stage III AKI (AuROCâ¯=â¯0.87), with an ideal cut-off of less than 200mls, with a sensitivity of 73.9% and specificity of 90.0%.CONCLUSION:
In ICU patients without severe CKD with mild AKI, a UFR of less than 200mls in the first 2â¯h after an FST is predictive of progression to stage III AKI. Future studies should focus on incorporating a FST as part of a clinical decision tool for further management of critically ill patients with AKI.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Atteinte rénale aigüe
/
Furosémide
Type d'étude:
Clinical_trials
/
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limites:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Langue:
En
Journal:
J Crit Care
Sujet du journal:
TERAPIA INTENSIVA
Année:
2019
Type de document:
Article